Bakgrund: Ungdomar i Sverige mår allt sämre psykiskt. Få söker hjälp hos vården när de mår dåligt. BUP har långa väntetider och därmed får få hjälp direkt när de behöver det. Ungdomar riskerar att försämras i sitt mående vid utebliven kontakt med vården. En app skulle kunna vara ett alternativ för dessa ungdomar innan de får möjlighet att komma till vården. Syfte: Studiens syfte är att belysa hur ungdomar som använder appen ”Här ligger jag…” uttrycker sitt mående. Metod: Studien har en kvalitativ ansats. Efter godkännande från användarna samlades data in från appen under en veckas tid, i mars 2020. Kvalitativ innehållsanalys användes för att analysera de 414 insamlade inläggen. Resultat: Resultatet består av fem kategorier av måenden. Det visade att ungdomarna har ett behov av att uttrycka sig kring ångest, depressiva symtom, ensamhet, hat och välbefinnande. Slutsats: Ungdomars behov att uttrycka sitt mående skulle kunna tillgodoses av en sjuksköterska med kunskap om ungdomar som ger vägledning till att hälsoappar finns att tillgå 24 timmar om dygnet. Ämnet psykisk ohälsa kan uppfattas som ett känsligt ämne att tala om och därför kan det vara lättare i ett forum där alla är anonyma. / Background: Mental health problems are increasing for adolescents in Sweden. Few of them seek help from health care when they are feeling unwell. Children and adolescents psychiatry in Sweden have excessive waiting lists for help seekers and therefore few who require help are getting it directly when needed. Adolescents are at risk of worsening their mental health status without available professional help. An mhealth app have the potential to be an alternative for adolescents with mental health problems before they have a chance to receive professional help. Objective: The aim of the study is to highlight how adolescents express their mood in the ”Här ligger jag…” app. Methods: This study has a qualitative approach to the field. The collection of data was carried out during one week in March of 2020 with consent from the users. A total of 414 posts was collected and analyzed using qualitative content analysis. Results: The result consist of five categories with expressions of feelings. It shows that adolescents have a need to express themselves about anxiety, depressive symptoms, loneliness, hatred and well-being. Conclusions: Nurses with knowledge about adolescents needs to express their mood could guide them to find mhealth apps which are available 24/7. Talking about mental health may be perceived as a difficult topic to discuss and therefore it may be easier in an anonymous forum.

Indiana University-Purdue University Indianapolis (IUPUI) / Introduction Mobile health (mHealth) applications (apps) are increasingly accessible and popular. In 2015, over 60% of smartphone users used their phones to look up health related information. mHealth apps related to maternal and child health (MCH) are particularly prevalent and frequently used. As high as 73% pregnant women and new mothers reported the use of MCH apps, with 27% using them daily. Methods A cross-sectional sample of MCH apps was extracted from the Apple App and Google Play stores using a JavaScript Scraper program. A multivariable linear regression, and series of ordinal logistic regression assessed the relationship between MCH app characteristics and two outcomes, end users’ perceived satisfaction (star ratings), and intent to use (downloads). Next, theory-based content analysis reviewed the presence and use of behavior change techniques (BCTs) in popular MCH apps using the mHealth app taxonomy framework. Finally, a qualitative inductive analysis assessed user self-reported experiences, perceived benefits, and general feedback for MCH apps. Results Seven hundred and forty-two apps met the inclusion criteria. A large majority of MCH apps were developed by non-healthcare developers. Google Play store apps had higher user ratings; while, apps within health & fitness genre, with older updates, and no agerestrictions had fewer user ratings. Furthermore, lower priced apps, with high star ratings, in-app purchase options, and in-app advertisement presence had high downloads. And, apps belonging to medical and health & fitness genre had fewer user downloads. Content analysis revealed that popular MCH apps on an average include 7.4 behavior change techniques (BCTs) with a median of 6 BCTs. Apps developed by healthcare developers had higher BCTs present within app content. Qualitative analysis shows that consumers value apps that are low cost, with superior features, smooth technical aspects, high quality content, and easy to use. Conclusions Healthcare providers, app developers, and policymakers may benefit from a better understanding of MCH apps available in two popular app stores and may consider strategies to review and promote apps to consumers based on information accuracy and trustworthiness. / 2020-11-06

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.

Context: The amount of Mobile Health (mHealth) applications to cultivate a healthy lifestyle or rehabilitate patients with physical or mental disabilities are increasingly available on app stores[1]. However, without a validation process, satisfactory results may not be obtained, especially for behaviour change apps.  Objectives: Discover validation tools with high adaptability and design a validation process of mHealth apps for behaviour change involving theoretical frameworks.  Methods: The author conducted a literature review of previous behaviour change theories, validation tools, and research methods to design a validation process for behaviour change apps. A mixed research method of preliminary questionnaire followed by semi-structured interview for limited amount of participants was proposed to empathy with users and evaluate features in the app. Lastly, a case study of a smoking cessation app (Myli) was practiced to examine the feasibility of the designed validation process. Results: A four-step validation process was designed as an instruction to validate mHealth apps step by step, especially behaviour change apps. From the case study, we obtained the knowledge and opinions through the survey and interview such as smoking behaviours, expectations and requirements on user experience, recommendations on features,etc, with five elder smokers and five younger medical students.  Conclusions: This paper contributes a validation study of mHealth apps that applying behaviour change theories and validation tools. Furthermore, the proposed validation process allows app developers or medical professions to adapt their own requirements in validation to meet the app users’ needs. / Sammanhang: Mobile Health (mHealth) applikationer för att bilda hälsosam livsstil eller att rehabilitera patienter med fysiska eller psykiska funktionsnedsättningar är alltmer tillgängliga i appbutiker [1]. Men utan en valideringsprocess kan tillfredsställande resultat inte erhållas, särskilt i appar för beteendeförändringar. Mål: Upptäcka valideringsverktyg med hög anpassningsförmåga och designa en valideringsprocess för mHealth-appar för beteendeförändringar som involverar teoretiska ramverk. Metoder: Författaren genomförde en litteraturgenomgång av tidigare beteendeförändringsteorier, valideringsverktyg och forskningsmetoder för att utforma en valideringsprocess för appar avsedda till beteendeförändringar. En blandad forskningsmetod av ett preliminärt frågeformulär som följs upp med en semistrukturerad intervju med ett begränsat antal deltagare föreslogs för att bättre förstå användare och utvärdera funktioner i appen. Slutligen praktiserades en fallstudie av en rökavvänjningsapp (Myli) för att undersöka genomförbarheten av den designade valideringsprocessen. Resultat: En valideringsprocess i fyra steg utformades som en instruktion för att validera mHealth-appar steg för steg, särskilt appar avsedda för beteendeförändringar. Genom fallstudien fick vi kunskaper och åsikter såsom rökbeteenden, förväntningar och krav på användarupplevelse, rekommendationer om funktioner etc genom enkäten och intervjun med fem äldre rökare och fem yngre läkarstudenter. Slutsatser: Denna artikel bidrar med en valideringsstudie av mHealth-appar som tillämpar teorier för beteendeförändringar och valideringsverktyg. Dessutom möjliggör den föreslagna valideringsprocessen apputvecklare eller de medicinska yrkesverksamma att anpassa sina krav i validering för att möta appanvändarnas behov.