Introduction: Mobile health applications (mHealth apps) may support people’s chronic obstructive pulmonary disease (COPD) self-management. Current research has demonstrated the promising effects of mHealth apps for people with COPD but there is still limited information on these apps’ characteristics and qualities, especially those in the public domain. Therefore, there is the need to use a standardized evaluation framework to: 1) describe characteristics and qualities of COPD apps from past studies; 2) characterize the features and qualities of public COPD apps; and 3) determine the appropriateness of public COPD apps from the perspective of clinicians and patients living with COPD. Methods: The mHealth Index and Navigation Database (MIND) framework, an objective evaluation tool was applied across studies. Project 1: A systematic review was conducted, including randomized controlled trials investigating interactive mHealth apps for people living with chronic lung diseases (CLD). Project 2: An evaluation study of the public marketplace (Android and Apple app stores) was conducted. Free mHealth apps created specifically for COPD self-management were included. Project 3: Reviewed COPD apps were presented to stakeholders in an infographic format. A RAND/UCLA Appropriateness Method (RAM) was used to collect feedback from stakeholders on the state of public COPD apps. Results: Many of the COPD apps trialed in past studies have inconsistent reports of their features and qualities, with many publicly unavailable. Most public COPD apps lacked clinical evidence to support their use and have questionable qualities. Stakeholders agreed that public COPD apps were mostly inappropriate but did not dismiss the need to discuss their potential in COPD care plans. Significance: This thesis project advocates for the partnership with multiple heath disciplines and patient-participants for app evaluations to gain stronger understanding of their potential. Future opportunities may include exploring other apps for lung diseases to promote stakeholder engagement throughout the process. / Thesis / Candidate in Philosophy

As an effect of increased living standards and improved health care, life expectancy has risen in many parts of the world. At the same time, welfare diseases such as diabetes and obesity increases. As the number of elderly and long-term sick rises, so will the medical care needs. E-health applications are often presented as a way to meet future medical and doing so within the scope of existing resources. By facilitating health communication and widen access to health services by offering them online, e-health applications encourages people to become more engaged in their own health, thus working proactively towards a healthier population. However, e-health applications often fail to reach their full potential. The purpose of this study is to explore how health care providers and health care recipients perceives e-health applications and their usefulness and thus being able to identify factors significant for successful introduction and use of e-health services. Two e-health applications have been analysed and six important aspects have been identified and discussed. In order to be successful, an e-health application must facilitate behaviour change and be integrated in the everyday life of the user. Substantial and adequate evaluation is essential to make sure that the application meet the requirements from both health care providers and health care recipients. An understanding of the possibilities technology has to offer is needed in order to fully exploit the potential of e-health applications in health care. Instructions for health care providers on how to use the applications are essential not only to ensure their proper usage but also to make sure that applications are being presented to recipients in a satisfactory way and that care providers can offer the support and help recipients may need. Finally, when discussing e-health applications it is important to remember that there are people who does not want to get involved and that there is still a demand for face-to-face interaction in health care. Therefore, e-health services must be complemented with alternatives providing different types of interaction opportunities.

This study investigates the perspectives of healthcare professionals regarding the integration of consumer health applications and patient-generated data into healthcare practices. Through semi-structured interviews with five healthcare professionals from different regions in Sweden, this thesis explores key features that are most valuable to health professionals in enhancing health personnel-patient collaboration as well as how patient-generated data from self-tracking applications can be best integrated into healthcare practices towards achieving health goals. The findings reveal a positive attitude towards these applications, with healthcare professionals recognizing their value in promoting patient engagement, facilitating data-driven decision-making, and enhancing collaboration between patients and providers. However, concerns regarding data reliability, privacy, and the need for seamless integration into existing workflows are highlighted. The study contributes to the understanding of healthcare professionals' perspectives and provides insights into the design and potential adoption and effective implementation of consumer health applications in healthcare settings.

To drink moderately can be hard for many people and there is a lot of norms that will amp up the temptation to drink more. In this essay the focus is to see what effect technology has when it comes to regulate alcohol consumption. The technology reviewed was the application Promillekoll, created by Systembolaget. This application gives the user an estimated value on what blood alcohol level the user had after consuming alcohol. By using different methods to collect data it helped to locate what kinds of norms there was when alcohol was being consumed and how they are playing a part in the regulation of alcohol. This essay also helped to figure out what kind of trust the user has for this type of application and what the application need so that the user will continue to use the application. The result indicate that the user can achieving a change in their behavior but they need the right attitude to achieve it. Many wanted an update of the features in the application to make it more appealing for them to use it, because the interaction in the application is not perfect. The main thing that hindering the application was the social norms that comes with drinking alcohol. / Att dricka lagom mycket kan vara svårt för många och det finns flera normer som ökar påfrestelsen att dricka mera. I denna studie ligger fokus på att ta reda på vilken effekt tekniken har när det kommer till att reglera alkoholkonsumtion. Den teknik som granskades är applikationen Promillekoll, som är en applikation framtagen av Systembolaget. Den ger  användaren ett uppskattat värde av ens promillehalt när de dricker. Men hjälp av olika metoder samlades data in för att ta reda på över vilka typer av normer som finns när det kommer till alkoholkonsumtion och hur de spelar in för regleringen av alkohol samt ta reda på hur stor tillit användarna hade till applikationen och vad som krävdes för att de skulle fortsätta användningen av applikationen. Resultatet tyder på att det går att uppnå en förändring med hjälp av applikationen men då krävs det att användaren har rätt attityd från början. Många respondenter ville däremot ha en uppdatering av applikationen då interaktionen inte var så effektiv som den skulle kunnat vara. Dock stod flera sociala normer i vägen för att tekniken skulle kunna vara effektiv.

Mobile health applications (mHealth apps), particularly in the health and fitness category, have experienced an increase in popularity due to their convenience and availability. However, this widespread adoption has raised concerns regarding the security and privacy of user data within these apps. This study investigates the security and privacy risks associated with ten top-ranked Android health and fitness apps, a set which accounts for 237 million downloads. By utilizing tools such as MobSF, Qualys SSL, and CLAUDETTE, we performed a static, dynamic, server-side, and privacy policy analysis in order to gain comprehensive insights into the security and privacy posture of the investigated mobile health and fitness apps. The results from the analysis revealed vulnerabilities in coding practices, hardcoded sensitive information, insecure encryption configurations, misconfiguration, and extensive domain communication. For instance, our analysis revealed that all apps stored their database API key directly in the code, with eight apps additionally exposing the database URL. Furthermore, six apps employed insecure encryption methods, such as CBC mode with PKCS5/PKCS7 padding (five apps) and ECB mode (two apps).In total, the apps interacted with 404 distinct domains. Notably, two apps communicated with more than 230 domains each, while a third app connected with over 100 domains. Despite these findings, developers demonstrated improved awareness and proficiency in addressing privacy and security risks compared to previous studies in the field. The study underscores the importance of continuous research to comprehensively understand the security and privacy landscape of health and fitness apps.

Made available in DSpace on 2016-03-22T17:26:44Z (GMT). No. of bitstreams: 1 Sergio.pdf: 4483896 bytes, checksum: fd6e9fa437d692c1d9468eadde90af71 (MD5) Previous issue date: 2011-03-05 / The ubiquitous medicine has the premisse to provide access to health services at any time, without restriction of location enhancing the mobility of doctors, nurses and other health professionals. These professionals need tools for information access, both at the site where the patient, either in other locations. The aim of this paper is to propose an infrastructure that integrates sensors and computing devices (mobile and fixed), considering the ubiquitous environment provided by a middleware and software architecture with context elements awareness, and also with the capacity acting on them. This architecture is called uMED, and their target applications will include monitoring vital signs of patients considering a typical work environment of staff working in medical emergencies. It is also being made to allow health professionals to remotely control (actuation) medical equipments. From the monitoring and/or actuation features, the intention is to enable an improvement in work routines of health professionals, helping to reduce the high percentage of nomadism and fragmentation of its activities. The uMED architecture is being designed with the perspective of being integrated with middleware EXEHDA. In order to evaluate the software architecture proposed for uMED, was developed a case study aimed at clinical follow-up of patients / A medicina ub´ıqua tem como premissa disponibilizar acesso aos servic¸os de sa´ude a qualquer hora, sem restric¸ oes de localizac¸ ao potencializando a mobilidade de m´edicos, enfermeiros e outros profissionais de sa´ude. Estes profissionais necessitam de ferramentas de acesso `as informac¸ oes, tanto no local onde se encontra o paciente, como n ao. O objetivo central deste trabalho ´e propor uma infraestrutura que integre sensores e dispositivos computacionais (m´oveis e fixos), valendo-se para isto do ambiente ub´ıquo provido por um middleware, e de uma arquitetura de software com sensibilidade para elementos de contexto, e tamb´em com capacidade de atuac¸ ao sobre os mesmos. Esta arquitetura ´e denominada uMED, e suas respectivas aplicac¸ oes alvo ir ao contemplar o monitoramento de sinais vitais de pacientes considerando um ambiente t´ıpico de trabalho das equipes que atuam em urg encias m´edicas. Tamb´em est´a sendo prevista a possibilidade dos profissionais de sa´ude controlarem remotamente (atuac¸ ao) equipamentos m´edicos. A partir das funcionalidades de monitoramento e/ou atuac¸ ao pretende-se possibilitar uma melhora nas rotinas de trabalho dos profissionais de sa´ude, contribuindo para reduzir o elevado percentual de nomadismo e fragmentac¸ ao de suas atividades. A arquitetura do uMED est´a sendo concebida com a perspectiva de ser integrada ao middleware EXEHDA. No sentido de avaliar a arquitetura de software proposta para o uMED, foi desenvolvido um estudo de caso direcionado ao acompanhamento cl´ınico de pacientes

Les récentes évolutions dans les technologies de l’information et de la communication, avec le développement de l’Internet, conduisent à l’explosion des volumes des sources de données. Des nouveaux besoins en recherche d’information émergent pour traiter l’information en relation aux contextes d’utilisation, augmenter la pertinence des réponses et l’usabilité des résultats produits, ainsi que les possibles corrélations entre sources de données, en rendant transparentes leurs hétérogénéités. Les travaux de recherche présentés dans ce mémoire apportent des contributions à la conception d’une Nouvelle Approche de Recherche d’Information (NARI) pour la prise de décision. NARI vise à opérer sur des grandes masses de données cataloguées, hétérogènes, qui peuvent être géo référencées. Elle est basée sur des exigences préliminaires de qualité (standardisation, réglementations), exprimées par les utilisateurs, représentées et gérées à l’aide des métadonnées. Ces exigences conduisent à pallier le manque de données ou leur insuffisante qualité, pour produire une information de qualité suffisante par rapport aux besoins décisionnels. En utilisant la perspective des utilisateurs, on identifie et/ou on prépare des sources de données, avant de procéder à l’étape d’intégration des contenus. L’originalité de NARI réside dans la métaphore de l’écart d’impédance (phénomène classique lorsque on cherche à connecter deux systèmes physiques hétérogènes). Cette métaphore, dont R. Jeansoulin est à l’origine, ainsi que l’attention portée au cadre réglementaire, en guident la conception. NARI est structurée par la dimension géographique (prise en compte de divers niveaux de territoires, corrélations entre plusieurs thématiques) : des techniques d’analyse spatiale supportent des tâches de la recherche d’information, réalisées souvent implicitement par les décideurs. Elle s’appuie sur des techniques d’intégration de données (médiation, entrepôts de données), des langages de représentation des connaissances et des technologies et outils relevant du Web sémantique, pour supporter la montée en charge, la généralisation et la robustesse théorique de l’approche. NARI est illustrée sur des exemples relevant de la santé / The recent developments in information and communication technologies along with the growth of the Internet have lead to the explosion of data source volumes. This has created many growing needs such as in information retrieval to: treat the information according to its usage context, to increase the relevance of answers and the usability of results, and to increase the potential correlations between results, which can be done by making the heterogeneities and source distribution transparent. Our contributions consist in designing a NARI (New Approach to Information Retrieval) for decision-making. NARI is designed to operate on large amounts of catalogued and heterogeneous data that can be geo-referenced. It is based on quality preliminary requirements expressed by users, which are represented and managed using metadata. These requirements lead to the lack of data or their insufficient quality in relation to decision-making needs. Using the users’ perspective, we identify and/or prepare the data sources, before integration step processing. NARI’s originality relies on the metaphor of the impedance mismatch (classical phenomenon when we try to connect two physical heterogeneous systems), due to R. Jeansoulin. This metaphor, as well as the attention paid to regulatory framework (standardization), guides the design of NARI. The geographical dimension structures NARI, taking into account various territorial levels, correlations between several themes. Thus, it takes advantage of spatial analysis techniques, by automating information retrieval tasks, often implicitly made by policy makers. NARI is based on data integration techniques (mediation, data warehouses), knowledge representation languages and a set of Semantic Web technologies and tools, adapted to support the scalability, robustness and generalization theory of the approach. NARI is illustrated on examples relevant to the health domain

People who are diagnosed with or suspect endometriosis or polycystic ovary syndrome (PCOS) are rarely included in the design of reproductive health applications, leading to a lack of functions useful to this user group. Non-normative user groups in general, including those experiencing endometriosis or PCOS, are also rarely mentioned in research of reproductive health applications or Human-Computer Interaction. Based on user requests, the aim of this thesis was to design new functions within the application Read Your Body aimed at their users experiencing endometriosis or PCOS. The project consisted of an iterative design process including research for design, sketching, prototyping, and user tests. It was found that this user group mainly wanted to track their symptoms and cycle to gain health insight, and a large number of tracking options and easy customisation was requested. The design process resulted in a design prototype that includes the ability to track symptoms, triggers, self-care practices and treatments as well as visualising and exporting data for personal health insight or to communicate with others. Knowledge created on the non-normative user group, their goals for tracking, and how to design reproductive health tracking applications for non-normative users could be useful in future research and design projects. The functions designed could improve understanding of self and communication with healthcare professionals, and inform diagnosis, treatment plans and self-care practices.

An unhealthy diet and insufficient physical activity lead to global health risks, where 70% of all deaths globally can be linked to non-communicable diseases. To change these types of behaviours, there are different methods, one of which is the Behaviour Change Wheel (BCW) which can serve as a guide to which methods can be used to achieve a behaviour change. The purpose of this study is to investigate how health applications can motivate users to a long-term health improvement. What are the important design factors in health applications for users, to be motivated to a long-term health improvement?   To fulfil the purpose, a study was conducted with a qualitative approach inspired by Design Science. For data collection, semi-structured interviews were conducted and data generated were analysed using thematic analysis.   The study showed that a number of the recommended Behavioural Change Techniques (BCTs) that could be found in BCW are consistent with respondents' personal experiences and opinions on desirable functions for achieving a healthier lifestyle. The results of this study indicate that important design factors in a health application are easily used functions that allow a user to find reliable information when needed, track their goals and evaluate these in relation to their previous achievements to continue to be motivated for  a long-term change. / En ohälsosam diet och otillräcklig fysisk rörelse leder till globala hälsorisker, där 70% av alla dödsfall globalt kan kopplas till icke smittsamma sjukdomar. För att förändra dessa typer av beteenden finns det olika metoder, där en av dem är Behaviour Change Wheel (BCW) som kan fungera som en fingervisning om vilka metoder som kan användas för att uppnå en beteendeförändring. Syftet med denna studie är att undersöka hur hälsoapplikationer kan motivera användare till en långvarig hälsoförbättring. Vad upplever användare är viktiga designfaktorer i hälsoapplikationer, för att motiveras till en långvarig hälsoförbättring?    För att uppfylla syftet har en studien genomförts med en kvalitativ ansats inspirerad av Design Science. För datainsamling har semistrukturerade intervjuer genomförts och den data som alstrats har analyserats med hjälp av tematisk analys.    Studien visade att ett antal av de rekommenderade Behavioural Change Techniques (BCTs) som kunde återfinnas i BCW stämmer överens med respondenternas personliga erfarenheter och åsikter om önskvärda funktioner för att nå en hälsosammare livsstil. Resultatet av denna studie pekar på att viktiga designfaktorer i en hälsoapplikation är smidiga funktioner som ger en användare möjlighet att finna tillförlitlig information vid behov, spåra sina mål och utvärdera dessa i relation till sina tidigare prestationer för att fortsatt motiveras att genomföra en långvarig förändring.

E-hälsa är och har varit på framväxt de senaste åren och idag finns mer och mer av vården tillgänglig digitalt. Denna utveckling sker också inom djurvården, men det finns inga vetenskapliga studier som beskriver djurägare som användare av digitala tjänster. För att utveckla riktade och användbara tjänster krävs god kännedom om målgruppen. Syftet med denna studie är att påbörja ämnet inom vetenskapen och kartlägga djurägares behov och inställning till digitala e-hälsotjänster för djur, och därmed skapa insikt kring målgruppens beteende och förväntningar. Denna information kan sedan användas i utvecklingen av tjänster där djurägare är den primära målgruppen. Genom en semistrukturerad explorativ enkätstudie samlades kvalitativa och kvantitativa data om svenska djurägare in. Studien grundades delvis på information från studier inom e-hälsa för människor och digitala vårdmöten. Utifrån den insamlade datan konstruerades fiktiva representativa användarprofiler, i.e. personas. Inom användarcentrerad design och utveckling är personas en välkänd metod för att på ett konkret sätt visualisera en tänkt användares behov och förutsättningar. Totalt 139 personer deltog i enkätstudien varav 39 personer hade använt en digital veterinärvårdstjänst. Majoriteten av deltagarna utgjordes av kvinnor och den största åldersgruppen var 26–45 år. Resultaten visar att djurägare är medvetna konsumenter som väljer djurvård med omsorg, då 62% någon gång aktivt bytt klinik. En överväldigande majoritet har försäkrat sina djur men ändå spelar ekonomiska faktorer stor roll för gruppen och påverkar deras val av djurvård. Resultatet indikerar att djurägare gör en aktiv bedömning innan de kontaktar veterinär, och att digitala veterinärvårdsapplikationer kan fungera som ett stöd i beslutsprocessen gällande om det är nödvändigt att besöka en fysisk klinik eller ej. Gruppen som använt veterinärvårdsapp är generellt mycket nöjda med tjänsten, även om flera påtalar det svåra i att visa upp skadan/djuret i ett videosamtal. / The e-health sector is growing rapidly, with more and more services becoming available to patients that allow them to digitally connect with their healthcare providers. E-health for pets has started to arise as well, but there is no research that covers the perspective of pet-owners as digital users. Good knowledge of the target user is critical for development of digital services that meet the wants and needs of end users. The aim of this study is to begin to remedy this research gap by mapping the mindset of pet owners, so as to provide greater insights into the behaviour and expectation of potential end users. This information can be utilized to further optimize and enhance user experience within development of applications where pet-owners are the target user. A semi-structured survey was created to collect quantitative and qualitative data and the survey sampled a wide range of Swedish pet owners. The survey was to some extent based upon information from studies within e-health for humans, with modifications made to apply to veterinary care. The gathered data was analyzed and used to create fictional user profiles, i.e. personas. Personas is a well-used method to visualize the needs and objectives of target users within user centered design and development. A total of 139 pet owners completed the survey. Only 39 had prior experience with digital veterinary applications. The majority of participants were female, and the largest age group were between 26 and 45 years. The results show that pet owners are aware consumers and carefully elect their pet care providers, as 62% actively have changed veterinary clinic. Even though an overwhelming majority of pet owners had pet insurance, economic factors were a key driver in determining pet care. The results indicate that pet owners evaluates the situation prior to contact with a veterinary, and that a digital veterinary app can be useful for pet owners by providing support in determining whether a visit to a veterinary clinic is necessary or not. Those that had prior experience with digital veterinary apps expressed that they were overall satisfied with the service, although several mentioned that it was difficult to accurately show the animal and the issue through video.