Regular physical activity, timely medication, controlled diet, and blood glucose monitoring is crucial for any diabetic patient. Laxity on following these treatment regimens can cause severe health complexity. Moreover, A physician’s surveillance on a patient, based on the patient’s real-time progress is difficult with the existing health care system. This research aims to provide a more accurate objective data in real-time to the physicians to help both patients and providers. The data being generated is mined later to investigate interesting questions regarding diabetic care. The resultant system is a mobile healthcare monitoring system for type – 2 diabetic patients that traces patients daily progress. Although many mobile apps provide self-monitoring tools for the patient, an interactive platform for monitoring all relevant parameters of diabetes where patients and physicians both are end users is unique. The Android app is designed with 3 major modules and two submodules: 1. Carb Intake Tracker (CIT), 2. Blood Glucose Tracker (BGT), 3. Physical Activity Tracker (PAT), 4. Medicine and 5. Blood Glucose (BG) reading reminder. Since Carb is an important factor for a diabetic patient’s meals, the CIT provides a platform to record daily meals from which the patient can see the total carb intake. Through BGT, patients can record their fasting or non-fasting blood glucose reading. The PAT collects a patient’s movement data via Bluetooth from a pair of wearable insole devices, and processing the data identifies and records the current activity. The PAT can detect if the patient is active in sedentary, as well as the type of exercise done by the patient. Using BG reminder and medicine reminder, the patient can set reminders which supports the apps self-monitoring aspect. All the data collected by CIT, BGT, and PAT are stored in Microsoft Azure cloud database, an authorized physician can access the database and see graphical statistics of a patient’s diet, physical activity, and glycemic index level. The app portrays statistics of carbs taken over a period, calories burned, and Glucose level trends through graphical representation. This has two advantages: 1. Patients can improve lifestyle observing records and following reminders, 2. Physicians can prescribe actions perceiving a patient’s trends over time. This research presents unique collaborative interaction between diabetic patients and physicians to create a real time patient portal based on android APIs and wearable devices.

Background: Public safety personnel (PSP) such as paramedics and police are exposed to traumatic situations which increases their risk for mental health issues. However, many PSP do not seek help in a timely manner. Peer support interventions have the potential to decrease stigma and increase treatment-seeking behaviours among PSP. However, little is known regarding how the organizational culture of public safety organizations (PSOs) may affect the implementation of a peer-based intervention. This study aims to understand the extent to which organizational culture, including masculinity contest cultures (MCC), within Canadian PSOs affects implementation of PeerOnCall, a new peer support app for PSP. Methods: A multiple case study design was adopted, integrating semi-structured interviews and a standardized MCC scale completed with organizational champions from three PSOs. Two to three champions from each PSO acted as key informants regarding their organizations. Interviews explored champions’ perceptions of how organizational culture might shape implementation. Interview data were analyzed using inductive thematic analysis. Interview data were also triangulated with MCC scale data to understand the extent to which an MCC exists and is important to consider when implementing this app-based intervention. Results: Interviews with champions resulted in the construction of four themes. The first theme focused on external drivers of organizational culture shift, while the second theme focused on internal drivers. The third theme focused on how culture can create resistance to implementation. The fourth theme emphasized that culturally competent implementation strategies could overcome this resistance Most participants perceived their organization to have low-to-moderate levels of MCC. Discussion/Conclusions: Each organization had a unique and changing culture, as evidenced through its cultural artifacts, beliefs, and values. Understanding how culture shapes implementation of PeerOnCall can guide the creation of contextually relevant strategies that optimize implementation of PeerOnCall within PSOs. Recommendations for strategies and further study are provided. / Thesis / Master of Public Health (MPH) / This multi-site case study explores how first responder culture influences implementation of the PeerOnCall peer support app. Interviews and surveys were conducted with seven workplace champions from one police and two paramedic organization(s). Interviews explored organizational culture in general while surveys focused on masculinity contest culture specifically. It was observed that: external and internal drivers of culture shift have created a window of opportunity for PeerOnCall implementation; cultures of mistrust, skepticism & apathy, and hegemonic masculinity can create resistance to implementation; and culturally competent implementation strategies can overcome this. Traditional norms of masculinity appeared to be changing within the organizations. While public safety organizations’ cultures have been studied, this study links culture to the implementation of a specific intervention and offers nuance to the issue of masculinity contest cultures. Findings can inform the creation of culturally competent strategies that optimize the implementation of resources such as PeerOnCall among first responders.

Telehealth and telemedicine have revolutionized the healthcare system in terms of access to information and remote medical treatment. While there is a great deal of literature on current perceptions of telehealth care systems, relatively little is known about perceived user needs and acceptance of future telehealth systems. One way to assess future attitudes is to evaluate anticipated usage of telehealth devices through perceived advantages and disadvantages. Additionally, this study seeks to assess the reliability of a new measure of technology acceptance that capitalizes on human motivation using self-determination theory. An online survey consisted of an original 40-item measure of motivation to use telehealth technology, the Psychosocial Impact of Assistive Devices Scale (PIADS; Jutai & Day, 1996), questions adapted from Edwards et al. (2014) about perceived advantages and disadvantages of telehealth devices, and open-ended questions about advantages, disadvantages, and concerns of interacting with telehealth devices in the future. The open-ended questions were coded for themes. Results also indicated that there was a high reliability between the MUTT and the PIADS, however the MUTT was slightly more reliable. Significant correlations were found between the overall MUTT and subscales of autonomy, competence, relatedness, and goals, as well as moderate correlations between the subscales of the PIADS (i.e., competence, adaptability, self-esteem) and the MUTT. The results of this research will be discussed further.

The societal problem of pediatric obesity is growing in Sweden with more patients receiving pediatric treatment while the treatment measures have not improved to match the increase. This exploratory study examines a mobile application aiming to improve treatment for pediatric obesity. The study will evaluate the current application through the lens of HCI with a focus on self-care and will be based on digital behavior change intervention (DBCI), persuasive systems, and playful user-centered design (UCD), with design recommendations stated based on the evaluation. User-centered design is a design process involving end-users in the design process, the users were involved through semi-structured interviews. User-centered design is a large part of the study with user input laying the foundation for new design recommendations. Users thought that the application would benefit from having more short-term goals to boost motivation. Furthermore, a heuristic analysis was done to get an expert view on the user interface. The results were promising and indicated some potential improvements for the application, one suggested improvement was to provide more positive feedback to boost motivation. The thesis discusses how more visualization of data might have the potential to both boost motivation and result in a more playful user experience. / Samhällsproblemet med barnfetma växer i Sverige med fler patienter som får pediatrisk behandling samtidigt som behandlings åtgärderna inte har förbättrats för att matcha ökningen. Denna explorativa studie undersöker en mobilapplikation som syftar till att förbättra behandlingen av barnfetma. Studien utvärderar den aktuella applikationen och är baserad på digital beteendeförändringsintervention (DBCI), persuasive systems och lekfull användarcentrerad design (UCD), med designrekommendationer angivna baserat på utvärdering samt semistrukturerade intervjuer. Användarcentrerad design är en stor del av studien med användarinput som lägger grunden för nya design rekommendationer. Intervjuerna lyfte fram att applikationen skulle tjäna på att ha fler kortsiktiga mål för att öka motivationen. Resultaten indikerade potentiella förbättringar för applikationen, exempelvis att ge mer positiv feedback. Slutligen diskuteras hur en mer genomarbetad visualisering av data kan leda dels till ökad motivation och dels till mer lekfull interaktion.

<p dir="ltr">FemTech is a booming subset of mHealth applications that was worth $51 billion in 2021 (Stewart, 2022b). FemTech largely focuses on menstruation, pregnancy, and fertility tracking. As with any technology, it comes with privacy and security risks for users, but these risks are more acute due to the sensitive nature of the data being collected. While privacy and security shortcomings have been highlighted for years, concerns were discussed widely in the United States after the Supreme Court released its <i>Dobbs v. Jackson</i> decision on June 24, 2022, which overturned <i>Roe v. Wade</i>, a 1973 decision that protected abortion as a constitutional right and limited states’ abilities to place restrictions on abortions. With abortion no longer a constitutional right, many states have outlawed or heavily restricted the procedure, and individuals expressed concern about their digital data being used in investigations as it has been in select previous cases (e.g., <i>State of Indiana v. Purvi Patel</i>, 2015; <i>State of Mississippi v. Latice Fisher</i>, 2018; <i>The State of Nebraska v. Celeste Burgess</i>, 2023; <i>The State of Nebraska v. Jessica Burgess</i>, 2023). While Big Tech has been scrutinized for turning user data over to law enforcement, many have more heavily questioned the protections offered by period tracking app companies due to the abundant amount of health data these companies possess about their users (e.g., Basu, 2022; Bradley et al., 2022; Cole, 2022). These apps have historically fallen short in protections for their user data in general (e.g., Beilinson, 2020; <i>Developer of Popular Women’s Fertility-Tracking App Settles FTC Allegations That It Misled Consumers About the Disclosure of Their Health Data</i>, 2021; Quintin, 2017). Clue is one of the most popular FemTech apps with millions of downloads across the Apple App Store and Google Play Store, and the company has spoken out widely about their privacy protections in the wake of the <i>Dobbs v. Jackson</i> decision (<i>‎Clue Period Tracker & Calendar</i>, n.d.; <i>Clue Period Tracker & Calendar</i>, n.d.; <i>Clue’s Response to Roe vs Wade Decision</i>, 2022). This research presents a forensic analysis of Clue on both iOS and Android after two months of data population, finding that some user-entered data was available in the app cache or .db-wal files on both iOS and Android but was entirely erased after the deletion of the app on the phones. This research also presents results from a survey of 31 menstruators in the United States, finding that online privacy in general is a concern for many users, and most find it unacceptable for period tracking applications to share user health data with advertisers or law enforcement.</p>

Mobile technologies are emerging as one way to help address health challenges in many countries, including in Least Developed Countries. Mobile technology can reach a large share of the population but in order to provide effective support to healthcare services, technology, information collection and dissemination, and work processes need to be well aligned. The thesis uses a design science methodological approach and mixes qualitative and quantitative data analysis to address the question of, How can mobile technologies be effectively integrated with routine healthcare services? The study concerns the design, implementation, and evaluation of a mobile technology-based system, called SMSaúde, with the aim of improving the care of patients with HIV/AIDS and tuberculosis in Mozambique. The work started with the elicitation of functional and user requirements, based on focus group discussions. An important challenge, as in many mHealth interventions, was the integration with routine healthcare services and the existing IT systems, as well as developing a scalable technical structure. The system has now been in routine use since 2013 in more than 16 healthcare clinics in Mozambique. Evaluation was done by a randomised controlled study. Analysis of patient records showed that retention in care in urban areas was significantly higher in the intervention group than in the control group. In a user study both patients and health professionals were very positive to the system. The thesis contributes to research by demonstrating how information system artefacts can be constructed and successfully implemented in resource-constrained settings. The practical contributions include the designed artefact itself as well as improved healthcare practices and mHealth policy recommendations.

This dissertation explores how people address problems of real human concern in situations of complexity, ambiguity, uniqueness, conflicting values and rapid change. Such circumstances stretch formal and idealistic rules and procedures to the breaking point. And yet, people in a variety of fields work through such difficulties in a pragmatic manner, at times finding ways to assert their humanity. Sensemaking and human- centred design are related activities through which many people approach such work. Through cases in digital innovation, global health care delivery and an unlikely voyage of the Amazon River, this portfolio shows that they are relevant to a wide range of settings. Rather than isolating the components or key variables of such work and taking their measure, this research advances a more holistic view of sensemaking and designing as sociomaterial practices. My research is grounded in performing the phenomenon of study, offering insights from complex practice rather than a spectator’s study of it. This ethnographic approach has yielded theoretical contributions related to designing for the emergence of practices, embodied sensemaking, a more substantive notion of what it means to be ‘human’ centred and more pragmatic ways of investigating sociomaterial practices. By discussing sensemaking and human-centred design as antidotes to failures of imagination in global health and development, this dissertation suggests a distinctive perspective on why these topics matter for the health of poor and marginalized people around the world.

Prologue is a health information system developed for underserved communities in Bihar, India. It is aimed at helping people living in poverty and with low literacy to take the right steps to manage their and their family’s health. Bihar suffers from one of the worst healthcare records in the country. This is as much due to the lack of access to the right information as it is due to the economic condition of the region. The inaccessibility of information is aggravated by the complex social set up in these communities, for e.g. women aren’t allowed to leave their homes and community has the strongest influence on an individual’s decision making. To make sure that right information permeates even to the most inaccessible user groups, especially women and to uplift community’s awareness as a whole, two different communication channels were designed-an interactive radio show and a public installation.

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.

Αντικείμενο της διπλωματικής εργασίας είναι η μελέτη της συμπεριφοράς των WBAN (Wireless Body Area Networks) σαν μέρος του συστήματος παρακολούθησης υγείας ασύρματης τηλεϊατρικής. Αρχικά γίνεται σύντομη αναφορά στον τρόπο χρήσης των WBAN για την πραγματοποίηση της ιδέας της mHealth (mobile health) καθώς και σε ενδεικτικά ερευνητικά προγράμματα της Ευρωπαϊκής Ένωσης που περιλαμβάνουν χρήση της τεχνολογίας WBAN και της τεχνολογίας ασύρματων εμφυτεύσιμων αισθητήρων για εφαρμογές ιατρικής περίθαλψης, ενώ στη συνέχεια γίνεται περιγραφή της αρχιτεκτονικής του συστήματος ασύρματης τηλεϊατρικής. Έπειτα, περιγράφεται η αρχιτεκτονική των δύο βασικότερων πρωτοκόλλων επικοινωνίας για ασύρματους κόμβους αισθητήρων, Bluetooth Low Energy και ZigBee/IEEE 801.15.4 και αναλύεται το επίπεδο εφαρμογής του πρωτοκόλλου ZigBee. Τέλος, περιγράφεται η αρχιτεκτονική του ασύρματου κόμβου αισθητήρων και παρουσιάζονται και περιγράφονται οι τυπικές συσκευές που χρησιμοποιούνται σε ένα WBAN ιατρικής περίθαλψης. / The purpose of my diploma thesis was the study of WBAN (Wireless Body Area Networks) as part of the wireless telemedicine health-monitoring system. I focused on the architecture of the integrated telemedicine system, the architecture of the two main communication protocols used in WBANs, Bluetooth LE and ZigBee/IEEE 801.15.4, and the specification of the ZigBee Application Layer. Finally, I described the typical architecture of the wireless sensor node and the typical devices that are used in a health WBAN.