Problem: A Major challenge for healthcare providers is the non-adherence of patients to prescrip- tions. One important area is hypertension treatment through medication. A treatment often starts with multiple adjustment cycles of medication type or dosage, which are based on regular at-home blood pressure measurements. Patients therefore need to adhere to regular medication intake and blood pressure measurements. Research Aim: The project first explored whether or not it is possible to develop a medication reminder system that checks patient adherence based on vital parameters. The project goal was adapted to the design and development of a reminder and data logging system for hypertension patients, based on the following research questions: 1) What are functional and non- functional requirements for the proposed artefact? 2) How can these requirements be implemented? Method: The project makes use of Design Science Research to create the system. The problem and requirement explication for the new artefact was achieved by working closely with a general prac- titioner who deals with hypertension patients. The artefact was evaluated by presenting it ex-post to a focus group of a hypertension patient, developers and founders in digital health. Results: The results of expert interviews concluded that the initial project aim is not feasible due to continuous vital monitoring being invasive and intrusive, lack of applicability for health conditions and medica- tions and other potential negative consequences. These insights led to the new research aim. The results address the question: ”What are functional and non-functional requirements for the proposed artefact?”. The envisioned product is a cross-platform application, illustrating the frequent medica- tion adjustments for hypertension patients. The treating doctor should configure all patient-specific parameters and the app should guide patients through daily tasks like measurements and medication intake. The patient should also be reminded of their tasks. The app should record, display, and export data for the doctor’s review, and ensure easy input of measurements. Future remote data exchange capabilities via servers were also considered. To address the research question ”How can these requirements be implemented?”, the researcher developed a cross-platform mobile application for iOS and Android with .NET Multi-Platform App UI (MAUI) that implements the desired features. A concept for remote data exchange and a system for scanning measured values of blood pressure devices were developed. The evaluation partially validated the problem area and discussed future implementations, such as remote data exchange, usage of patient data for research and adoption to other medication. The perceived high usability of the application was emphasized. Conclusions: The researcher concludes that the developed artefact addresses a relevant problem and extends existing solutions in the problem space. It is acknowledged that future research has to be conducted to prove the effectiveness of the tool as well as assess its usability and accuracy. Difficulties for accepting the artefact in real life settings are discussed.

This work explores the acceptability of various persuasive design principles for pediatric users of a digital, asthma self-management solution. While persuasive design methods have been shown to motivate adherence to digital self-management, effective persuasion is highly context-dependent. The gap in research on persuasive design for younger users of asthma self-management applications raises the question of which persuasive principles are acceptable for this group’s unique context. This question is explored through the Persuasive Systems Design model. Based on interviews and workshop feedback from physicians, six persuasive principles were chosen for a redesign of an existing asthma self-management solution. The prototype was evaluated for potential acceptability by user proxies. The Personalization and Simulation persuasive principles were perceived as most acceptable for pediatric, digital asthma self-management. / Detta arbete undersöker hur pediatriska användare upplever acceptansen av övertygande designprinciper av ett digitalt självhanteringsstystem för astma. Även om övertygande designmetoder har visat sig motivera att man följer digital självhantering, är effektiv övertalning mycket kontextberoende. Den vetenskapliga kunskapsluckan rörande övertygande design för yngre användare väcker frågan om vilka designprinciper som anses vara acceptabla för denna grupps unika sammanhang. Denna fråga utforskas i detta arbete genom modellen för övertygande systemdesign. Baserat på intervjuer och workshops med läkare valdes sex övertygande designprinciper ut för att designas om för ett befintligt självhanteringssystem för astma. Designprototypen utvärderades med avseende på potentiell acceptans av användarproxys. Resultatet av undersökningen visade att personifierings- och simuleringsövertygande designprinciper uppfattades som mest acceptabla för pediatrisk, digital självhantering för astma.

Maternal morbidity and mortality are prevalent issues worldwide that profoundly affects low- and middle-income countries (LMICs) in Africa. Estimates vary, but by the end of 2015, at least 300,000 women died in LMICs due to preventable pregnancy and childbirth conditions. Pregnant women die from complications that could be detected and managed if they were able to receive early access to necessary health interventions. Mobile technology is increasingly common across the globe, including LMICs, and incorporating digital health technologies, especially mobile phone (mHealth) programs, can offer a possible solution to morbidity and mortality related to pregnancy. A literature review analyzing the impact of mHealth programs on maternal health was conducted from various online databases. Nineteen articles that were published in the last ten years and contained technology-based interventions used for maternal health were reviewed. Inclusion criteria included countries listed as low-income and middle-income in the 2017 World Bank list of economies. The studies suggest mHealth programs have the potential to reduce maternal morbidity and mortality by increasing knowledge of safe health practices for pregnant women, community health workers, and traditional birth attendants. Mobile health technology also provides crucial information to providers when complications arise and can improve health facility utilization leading to increased deliveries with skilled birth attendants. This reinforces the need for more mHealth initiatives to be implemented in LMICs, addressing the barriers and community characteristics to positively impact and reduce maternal death in these settings.

Human activity recognition based on wearable sensors’ data is quite an attractive subject due to its wide application in the fields of healthcare, wellbeing and smart environments. This research is also focussed on predictive performance comparison of machine learning algorithms for activity recognition from wearable sensors’ (MHEALTH) data while employing a comprehensive process. The framework is adapted from well-laid data science practices which addressed the data analyses requirements quite successfully. Moreover, an Analysis Tool is also developed to support this work and to make it repeatable for further work. A detailed comparative analysis is presented for five multi-class classifier algorithms on MHEALTH dataset namely, Linear Discriminant Analysis (LDA), Classification and Regression Trees (CART), Support Vector Machines (SVM), K-Nearest Neighbours (KNN) and Random Forests (RF). Beside using original MHEALTH data as input, reduced dimensionality subsets and reduced features subsets were also analysed. The comparison is made on overall accuracies, class-wise sensitivity and specificity of each algorithm, class-wise detection rate and detection prevalence in comparison to prevalence of each class, positive and negative predictive values etc. The resultant statistics have also been compared through visualizations for ease of understanding and inference. All five ML algorithms were applied for classification using the three sets of input data. Out of all five, three performed exceptionally well (SVM, KNN, RF) where RF was best with an overall accuracy of 99.9%. Although CART did not perform well as a classification algorithm, however, using it for ranking inputs was a better way of feature selection. The significant sensors using CART ranking were found to be accelerometers and gyroscopes; also confirmed through application of predictive ML algorithms. In dimensionality reduction, the subset data based on CART-selected features yielded better classification than the subset obtained from PCA technique.

This study examines the technology and appointment scheduling habits of older adults over the age of 55 through an exploratory sequential three phase mixed methods study. Phase One of this study examined features of ten existing mHealth applications through a qualitative content analysis, then a mHealth wireframe was developed from the app to replicate in addition to a redesigned version. Phase Two of the study was a thirty-four questions survey with 40 participants that inquired about their background with appointment scheduling, prior experience with technology, and demographics. After that, the mHealth applications were revised into two mHealth application prototypes. Lastly, Phase Three conducted a user test with the two mHealth prototypes through A/B testing with 15 participants. Findings from the survey showed the preferred method of scheduling an appointment among participants was primarily in-person or by phone. The user test revealed that some participants were willing to use a mHealth application to schedule an appointment if it was deemed easy to use. Recommendations for future research suggests that the iterative design process of a prototype with an underserved population would garner feedback inclusive of those older adults who are less tech savvy. The major contribution of this research was the development of the mHapps Framework which will be tested in a future study.

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.

Stroke is a leading cause of death and disability worldwide [8], underscoring the need for effective digital solutions for stroke patients, caregivers, and healthcare professionals. Given that, this thesis aims to evaluate quality aspects of usability, accessibility, and readability of stroke-related mobile health (mHealth) applications, with the primary objective of identifying strengths and weaknesses to enhance user experience and app quality. This study assessed sixteen stroke-related apps through a comprehensive methodology, including accessibility testing with the Google Accessibility Scanner, Mobile Application Rating Scale (MARS) evaluation, heuristic evaluation, and readability assessment. Key findings indicate significant issues with touch target sizes and text contrast, which are crucial for users with impaired visionand motor skills. MARS evaluations revealed that “Constant Therapy” excelled in engagement and functionality due to its interactive features and personalized schedules. At the same time, “Stroke Recovery Predictor” and “Conversation Therapy Lite” scored lower due to limited functionality and unclear interfaces. The heuristic evaluation highlighted frequent violations of the visibility of system status and insufficient error messaging. Readability assessments showed a range of reading difficulty levels, with some apps lacking privacy policies that could be found either within the application or on the developer’s website. The study provides actionable recommendations for developers, such as improving touch target sizes, improving text contrast, increasing functional variety, optimizing navigation, and ensuring privacy policy transparency. Addressing these areas can significantly improve the usability and accessibility of stroke-related mHealth apps, ultimately supporting better health outcomes and quality of life for stroke survivors. Future research should involve more evaluators, use multiple assessment tools, and focus on specific types of stroke apps to refine the evaluation process and provide more targeted insights.

Syftet med uppsatsen var att undersöka hur man med hjälp av digital design kan stödja den psykiska hälsan hos individer i USA under Covid-19 pandemin. Covid-19 är den första pandemin som utspelar sig i ett utvecklat digitalt samhälle där både mHealth/telehealth-design är välstuderat. Studien undersöker specifikt hur designelement för en mHealth-applikation kanen mHealth-applikation kan stödja en stor grupp användare under en global pandemi. Uppsatsen undersöker hur design kan öka användandet av mHealth för att söka hjälp mot psykisk ohälsa, som uppstått på grund av isolering till följd av den amerikanska statens riktlinjer under Covid-19 pandemin. Med hjälp av tidigare forskning gällande designriktlinjer för mHealth-applikationer, inkluderande design och element att tänka på när man designar applikationer för psykisk ohälsa, framtogs en prototyp av en mHealth-applikation. Denna prototyp testades därefter av sex respondenter som alla lider av depression till följd av isolering. Efter think aloud-observation under testandet av prototypen genomfördes en kvalitativ intervju för att undersöka respondenternas upplevelse av applikationen. Resultatet av studien påpekar vikten av användarens integritet, inkluderande design och element som efterfrågats i tidigare studier av mHealth-applikationer. Dessa resultat stödjer också de åtaganden tidigare forskninglagt fram och i sin tur visar denna studie att en mobilapplikation kan designas föratt stödja människor med deras psykiska ohälsa i relation till Covid-19 isoleringen. / The goal of this thesis was to investigate how the use of digital design could help people with their mental health during the covid-19 pandemic. Covid-19 is the first and only pandemic where both mHealth and telehealth design has been well developed. Our thesis explores how design elements can increase the will of users to use mHealth applications, especially for users whose mental health has been impacted by covid-19 restrictions in the United States. Based on the scientific articles regarding mHealth design, a prototype was made. This includes inclusive design and design elements focused on people with mental health struggles. The prototype was tested by six users who all reported feeling down because of isolation during covid-19. During the study, users were asked to test the prototype and ‘think aloud’, followed by a qualitative interview to better understand the user’s experience, feelings, and thoughts on the prototype. The results show the importance of a patient's integrity, the importance of inclusive design, and the appreciation of certain design elements. The results are in line with results from previous research and offer evidence on how to design a mHealth application to support people with their mental health during a pandemic.

En 2015, avec 7 milliards d'usagers, le téléphone portable devient la technologie de communication la plus utilisée dans le monde. Du rappel de rendez-vous par SMS au glucomètre mobile, les systèmes de santé y recourent de manière croissante. Les programmes qui utilisent le téléphone portable pour améliorer la santé constituent un nouveau secteur de la télésanté appelé mHealth ou mSanté. Peu de recherches ont été réalisées sur leur déploiement en particulier dans les pays du Sud. A travers l'étude d'un programme global de santé maternelle au Ghana et Inde, la thèse apporte un premier regard sur ces dispositifs. S'appuyant sur une enquête multi-située et des méthodes de sociologie de la santé, des usages et d'analyse de discours, elle précise les assemblages sociotechniques propres à ces objets dans le champ biomédical mondialisé et se penche sur l'action effective des technologies mobiles sur la prise en charge et la santé des femmes ciblées. Cette triple approche permet de mettre en lumière les enjeux de pouvoir sous-jacents au développement de cette technologie dans les Suds. La thèse explore d'abord le modèle de « développement numérique » promu par les dispositifs de mSanté : un modèle qui établit une relation particulière aux savoirs et à la science, qui intègre l'expansion des technologies numériques d'une part et de leurs marchés d'autre part comme source de progrès et de croissance pour les Suds. Ce modèle techniciste et mercantile du développement reconduit des logiques impérialistes et déplace des inégalités Nord-Sud. Ensuite, la thèse analyse la place de l'information et des données de santé dans ces projets. Présentées comme le moyen principal de combattre la mortalité prématurée et de maintenir en bonne santé les populations, la responsabilisation du patient dans une logique consumériste et béhavioriste et la mise en données de la santé à des fins de surveillance caractérisent le dispositif étudié. L'enquête montre que le soin ne peut être entièrement capturé par des techniques d'encodage et de transmission et qu'en cherchant à rationaliser les services de santé à travers la sous-traitance du soin à des patients « informés » et à des personnels bon marché et précarisés, le dispositif technique dégrade les relations interpersonnelles indispensables au soin. Enfin, la thèse examine les rapports de pouvoir multiples dans lesquels s'inscrit la mSanté. Les acteurs de la mSanté déploient des programmes ciblant les femmes et entendent compenser des inégalités de genre grâce au téléphone portable, considéré comme un outil d'empowerment. Le dispositif étudié participe de cette tendance mais ne tient pas compte de la structure complexe des rapports de genre et propose de manière superficielle une inversion des rôles sans travailler sur les facteurs et les sphères de détermination. L'enquête multi-située montre comment loin d'annuler des relations inégalitaires, le dispositif technique transforme des inégalités de manière différente selon son contexte d'insertion. L'idée que les technologies numériques permettent une amélioration de la prise en charge, une diminution des disparités de santé et une optimisation des systèmes de santé a pris corps ces dernières années dans un ensemble de dispositifs techniques variés. Ainsi, la mSanté dans les pays en développement participe d'un mouvement plus général de globalisation et de technologisation de la biomédecine. L'analyse dépasse donc le cas de la téléphonie mobile pour montrer comment les technologies numériques participent à l'émergence de nouveaux pouvoirs, à la globalisation et à la mise en données de la santé, à la transformation du soin et des pratiques de santé. / With 7 billion mobile users in 2015, mobile phones became the most widespread communication technology worldwide. From appointment reminders by SMS to mobile glucometers, healthcare systems are increasingly using mobile technologies. However, the use of mobile technologies for health called « mhealth » or « mobile health » has not been well documented so far, especially in the Global South. Through the study of a global mHealth program on maternal health implemented in Ghana and India, this research offers a first glance at those devices. Based on an interdisciplinary approach combining sociology of health, users studies and discourse analysis, and a multisite ethnography conducted in Ghana and India, this dissertation describes those particular socio-technical assemblages deployed in a global biomedical context and details the specific impact of those mobile technologies on care provision and health practices for women targeted by those programs. This triple approach reveals power relations underlying the expansion of those new technical artefacts in the Global South. First of all, this work examines the model of « digital development » promoted by mHealth programs: a model that establishes a special relation to knowledge and science, that defines mobile connectivity and mobile market extension as key sources of progress and economic growth in the developing world. This technological and market-based model of development perpetuates imperialist dynamics and reshapes North-South inequalities. Moreover, the thesis studies the role of information and health data in those projets. Seen as central weapons to fight mortality and to preserve health for everyone, patient empowerment and data-driven health are strong characteristics of the studied device that increase the commodification and datafication of health. The research shows that care practices cannot be entirely captured by encoding and transmission techniques, by delegating care to the « digitally engaged patient » and to poorly trained-insecure-low-paid healthworkers, the project deteriorates interpersonal relationships that are essential for care practices. Finally, the thesis examines the multiple power issues at stake in mHealth projects. Those maternal programs are specifically targeting women and intend to compensate gender inequalities thanks to the alleged empowering effect of mobile phones. The studied program contributes to this trend and offers a shallow inversion of the traditional assignment of gender roles thus hardly taking into account the complexitiy of gender determination. This multisite research shows how the technical device far from erasing inequalities transforms them in different ways depending on its context of insertion. The idea that digital technologies contributes to improving care, reducing health disparities and optimizing health systems has taken shape in recent years in a diverse set of technical devices. mHealth or mobile Health is a particular vector of this global movement, which goes beyond the use of mobile phones, and shows how digital technologies contribute to the emergence of new powers, to the reorganization of care, to the globalization, the datafication and the commodification of health.

Το mHealth, η χρήση δηλαδή φορητών τεχνολογιών για την βελτίωση των παρεχόμενων υπηρεσιών υγείας, είναι σήμερα ένα από τα πιο ταχέως αναπτυσσόμενα πεδία της ηλεκτρονικής υγείας (eHealth). Ο αριθμός των επαγγελματιών υγείας που υιοθετούν έξυπνα κινητά τηλέφωνα (smartphones) για την εκτέλεση πληθώρας λειτουργιών αυξάνεται συνεχώς, εξαιτίας των δυνατοτήτων και της φορητότητας που αυτά παρέχουν. Ταυτόχρονα, τα σφάλματα στη φαρμακευτική αγωγή είναι από τα πιο συνηθισμένα ιατρικά λάθη με επιπτώσεις τόσο στην υγεία του ασθενούς όσο και στις δαπάνες στην υγεία. Η χορήγηση φαρμάκων είναι μια πολύπλοκη διαδικασία, καθώς απαιτεί από τον ειδικό της υγείας την ανάλυση πληθώρας παραγόντων και την ανάκτηση, επεξεργασία και διαχείριση μεγάλου όγκου πληροφορίας. Σύμφωνα με τη βιβλιογραφία, η χρήση τεχνολογιών πληροφορικής για την υποβοήθηση των επαγγελματιών υγείας στη λήψη αποφάσεων κατά τη συνταγογράφηση, μπορεί να συμβάλει σημαντικά στη μείωση των σφαλμάτων φαρμακευτικής αγωγής. Στο πλαίσιο της παρούσας διπλωματικής εργασίας, προχωρήσαμε στη διερεύνηση και αξιολόγηση των σημαντικότερων εφαρμογών έξυπνων κινητών συσκευών για το φάρμακο, με στόχο την εξαγωγή χρήσιμων συμπερασμάτων για τα χαρακτηριστικά και τις λειτουργίες που ενσωματώνουν. Ένα από τα βασικά συμπεράσματα της έρευνας ήταν η απουσία αντίστοιχης εφαρμογής για τα φάρμακα που είναι εγκεκριμένα από τον Εθνικό Οργανισμό Φαρμάκων (ΕΟΦ). Ως εκ τούτου, προχωρήσαμε στο σχεδιασμό και την ανάπτυξη εφαρμογής για τον έλεγχο ασυμβασιών μεταξύ φαρμάκων, η οποία παρέχει επιπλέον τη δυνατότητα προβολής πληροφοριών συνταγολογίου για τα φάρμακα του ΕΟΦ. Ο σχεδιασμός της εφαρμογής έγινε λαμβάνοντας υπόψη τις ανάγκες και τις απαιτήσεις μελλοντικών χρηστών, όπως οι επαγγελματίες υγείας και οι ασθενείς, προκειμένου να διασφαλιστεί η λειτουργικότητα και η ευχρηστία της. Η εν λόγω εφαρμογή προορίζεται για έξυπνες κινητές συσκευές που διαθέτουν λειτουργικό σύστημα Android, ενώ η πληροφορία που ενσωματώνει βασίζεται αποκλειστικά στο εθνικό συνταγολόγιο του ΕΟΦ. / Mobile Health or mHealth, namely the use of mobile and wireless technologies in order to improve health services and achieve health goals, is today one of the most rapidly expanding fields of electronic health (eHealth). The number of health professionals that adopt smartphones to perform multiple tasks, during their everyday medical practice, is increasing constantly. This is due to the fact that smartphones provide advanced computing capabilities and high portability. Simultaneously, medication errors are among the most common medical errors which have negative impact both for the health of the patient and the expenditure on health sector. Drug prescribing is quite a complex procedure, considering the fact that requires the health expert to analyze multiple factors and retrieve, process, manage and digest large volume of information. According to the literature, the use of information technologies to assist health professionals in decision-making when prescribing drugs, can contribute significantly to the reduction of medication errors. In the context of our work, we explored and evaluated the major smartphone applications for drugs, aiming to the extraction of useful conclusions about the features and functions that they incorporate. One of the research key findings was the absence of a corresponding application for the drugs that are approved by the National Drug Organization of Greece. Therefore, we design and develop an application for checking drug-drug interactions which additionally provides the ability to view national formulary information about drugs. The analysis and design of the application was implemented in collaboration with future users, such as health professionals and patients, in order to ensure that will meet their needs and requirements and at the same time will remain user friendly. This application is intended for Android smart mobile devices (e.g. smartphones, tablet PCs) and the information that integrates is solely based on the national formulary of the National Drug Organization of Greece.