Background. The use of mobile technology has become more prevalent within the delivery of healthcare (m-health) within the developing world. Its use is considered convenient and innovative, but little is known about its effectiveness. Although promising, there is a lack of literature pertaining to its overall effectiveness. Purpose. This study takes the perspectives of threes groups of key stakeholders to describe the m-health service and the perceived benefits of using the mobile health technology implemented by BRAC in the urban slums of Korail, within the capital city: Dhaka, Bangladesh. Methods. The study uses an exploratory descriptive case study design. The methodology includes demographic questionnaires, and semi-structured interviews. The sample included three groups: the BRAC developers, the community health workers (CHWs) and the villagers. Conclusion. This study described the perspectives of those involved with the service, defining the m-health service as well as highlighting four major themes: strengths and benefits, knowledge and awareness, challenges and barriers and areas of improvement. The emerging themes found in the study provide paradigms of what to expect when implementing pilot m-health innovation and suggests direction for growth and sustainability. / Thesis / Master of Science (MSc) / The purpose of the study is to understand the new mobile health (m-health) service started by BRAC in the urban slums of Dhaka Bangladesh. This is carried out by asking questions to the people who use the service the most: the BRAC developers, the community health workers (CHWs) and the villagers.

Sleep concerns are prevalent and can have a detrimental impact on the overall functioning of an individual. Nightmares, specifically, have been tied to a myriad of adverse mental health outcomes and are known to exacerbate other medical/mental health symptoms. Further, nightmares appear to persist after treatment of other concerns such as posttraumatic stress, depression, and anxiety. Although many treatments exist for nightmare disorder and posttraumatic nightmares, only Imagery Rehearsal Therapy has continuously been cited as first line treatment (Morgenthaler et al., 2018). Mobile health (mHealth) technology has emerged as a viable avenue for exploration in the mental health field as technological advances are becoming commonplace in integration of clinical practice to increase accessibility. Research suggests that using mobile modalities may be a feasible way to provide sleep interventions; however, research has yet to fully explore this possibility. This project assessed a mobile application called Dream EZ released by the National Center for Telehealth and Technology, which is based on Imagery Rehearsal Therapy, but has yet to conduct research on its effectiveness. The primary purposes of this project were to (1) explore the effectiveness of smartphone-based mHealth application treatment (Dream EZ) in reduction of psychological symptoms as compared to waitlist control and (2) evaluate adherence and acceptability of treatment via smartphone application. Findings from the study support use of mHealth nightmare treatment for nightmares distress reduction (main effect: p =.010, d = .53; interaction: p =.145, d = .30). Results regarding effectiveness of mHealth treatment were inconclusive as analyses were underpowered in relation to reduction of PTSD symptoms (main effect: p =.415, d = .17; interaction: p = .262, d = .23) and suicidality (main effect: p =.007, d = .57; interaction: p =.758, d = .07). Treatment adherence and acceptability were not significantly associated with nightmare symptom reduction. Although some hypotheses were underpowered, the strength of this study laid in its use of a randomized control trial hybrid-2 study design and its timely look at viability of technology use in clinical treatment. Future directions include replication within a clinical population and in various settings such as primary care clinics.

Technology plays an increasingly important role in modern health care. This thesis presents an approach to usability evaluation of mobile information and communications technologies designed for diabetes patients&rsquo / use in their daily lives. According to our study conducted on 60 diabetes patients, several important findings were obtained. Fifty nine (98.3%) diabetes patients were highly satisfied with the mobile health technology and expressed that they would use it, and found the measured values reliable. For 57 (95%) diabetes patients / measuring, checking and accessing the blood glucose level easily anytime and anywhere were very important. Fifty six (93.3%) said that they would wish to send their blood glucose levels to their physicians via e-mail. When participants were asked to provide a decision on future health care, predominate number of participants said they would change their lifestyle rather than visit a doctor regardless of their blood glucose level. In conclusion, little is known about such effects of mobile information and communications technologies in self-management care situations. It is clear that usability studies in the field are more difficult to conduct than laboratory evaluations. Further studies with larger sample sizes are needed to further evaluate these initial findings.

Problem formulation. The European Commission considers that health care providers and potential payers may need further evidence of mobile health (mHealth) clinical and economic benefits and despite there are hundreds of mHealth initiatives, most of them did not move beyond the pilot phase.   Purpose. This thesis aims at analyzing how can mHealth companies contribute towards solving existing health care challenges while becoming successful businesses in such an immature market. The expected results are a set of empirical evidences for companies and investors interested in this relatively new industry for the development of successful businesses, products and services.   Literature. The authors have explored classic theories and models on market entry, business and strategy development in combination with recent studies on health care, Internet and mHealth economy and ecosystem.   Methods. A qualitative multiple case study has been conducted. An analytical framework with propositions derived from the literature analysis guide the empirical study of two organizations that have successfully developed mHealth solutions in two countries with different socio-economic situations: China and Spain. Organization A is a health care and lifestyle company from Beijing responsible for a successful app with 80 million users that has brought 45 million USD investment. Organization B is the first intrapreneurial public organization born within a hospital in Madrid and committed to make knowledge available to patients and health care professionals through ICT. After a set of interviews with executive representatives and project managers, a pattern-matching analysis has been used to extract inferences and to identify correlations and deviations from literature research.   Key findings. The main conclusion of this thesis work is that mHealth is clearly a profitable blue ocean industry nowadays with lots of business opportunities to explore, room for competition and complex challenges to solve. On one side, mHealth is presented as a disruptive industry expected to cause a big impact in health care by contributing to solve costs and quality problems although there is little evidence on such benefits. On the other side, privacy, security, regulations, governments’ decisions and reluctant health care professionals become the main barriers for adoption. The outlook for the future of mHealth proves that it will be fundamental to count with multidisciplinary teams of professionals, geographically distributed health centers and technological platforms with secure and standardized communications. All these will not be possible without a general mindset change from government, administrators, regulators and health care professionals to incentivize and foster new mobile health technologies treating them as an ally rather than a threat.

Thesis (M.S.P.H.)--University of Michigan, 1940.

Thesis (M.S.P.H.)--University of Michigan, 1940.

Background - Mobile health (mHealth) interventions to promote medication adherence have shown promise; among patients primarily diagnosed with Coronary Heart Disease (CHD), however, there is a lack of evidence for nurse-led mHealth interventions, in this particular group in Iran. Aim - To refine and evaluate a pre-developed nurse-led mHealth intervention to promote cardiovascular medication adherence in Iranian adult, male and female Cardiac Rehabilitation (CR) outpatients. Methods - A quantitative-dominant mixed methods study was conducted drawing upon the Medical Research Council’s (MRC) Framework on the development and evaluation of complex interventions. Phase 1 comprised of a self-completion CHD patients’ survey (n=123) and three focus groups with cardiac nurses (n=23) within three public university-affiliated hospitals in Tehran, which in turn informed Phase 2 (the exploratory trial phase). The automated Short Message Service (SMS) medication reminder was designed based on the dimensions of adherence suggested by the World Health Organisation (WHO) and Bandura’ Self-efficacy Theory. The intervention was refined according to the findings from Phase 1 and then piloted in an Iranian CR setting. Seventy eight CHD patients who were 18 years or older, and had mobile phone access were recruited and randomised to receive either daily SMS reminders (n=39) or usual care (n=39) for 12 weeks. The primary outcome was the effect on cardiovascular medication adherence as measured by the self-reported Morisky Medication Adherence Scale; secondary outcomes explored the feasibility of the mHealth intervention, intervention effect on medication adherence selfefficacy, cardiac ejection fraction, cardiac functional capacity, hospital readmission/ death rate and health-related quality of life. Patient acceptability was assessed through completion of a post-intervention survey. Results - Feasibility was evidenced by high ownership of mobile phones in CHD patients, high application of SMS messaging, positive patients’ perception about the intervention, suboptimal cardiovascular medication adherence and patients’ high interest in receiving SMS reminders for their medications. Participants in the intervention group showed higher self-reporting of medication adherence compared to the usual care group χ2 (2) = 23.447; P < 0.001. The Relative Risk (RR) was indicated that it was 2.19 times more likely for the control group to be less adherent to their medications than the intervention group (RR = 2.19; 95% Confidence Interval (CI) 1.5 - 3.19). All secondary outcomes improved in the intervention group at the end of the study. Acceptability was evidenced by participants who received the intervention reporting that they perceived the SMS reminders useful. Conclusion - The SMS medication reminder intervention was well accepted and feasible with significantly higher reporting of medication adherence in Iranian CHD patients. Effect sizes were established for use in future follow-up evaluations of the mHealth intervention.

No description available.

BACKGROUND: Despite the growing popularity and widespread adoption of mobile mental health apps, there is still insufficient high-quality evidence demonstrating their safety and efficacy. Aims: This exploratory analysis investigates the potential effect size of mindLAMP, a smartphone mental health app, on reducing symptoms of depression and anxiety by comparing the results of using mindLAMP in a control implementation and in a intervention implementation. METHODS: A total of 238 participants were eligible and finished the study in the control implementation, while 156 participants completed the study in the intervention implementation of the mindLAMP app. All participants (both groups) had access to the same in-app activities, including self-assessments and therapeutic interventions. RESULTS: After multiple imputation, analysis revealed significant minor effect sizes of Hedge’s g = 0.21 and Hedge’s g = 0.34 in the reduction of depression and anxiety symptoms respectively. CONCLUSIONS: MindLAMP demonstrates a promising potential in reducing symptoms of depression and anxiety. Additionally, this study underscores the adaptability, reusability, and scalability of smartphone apps, as they can be implemented in diverse settings. These results serve as a basis for further research to examine the effectiveness of not only mindLAMP but also other mental health apps in addressing symptoms of depression and anxiety.

Typical hospital setups comprise units such as clinics, inpatient wards, outpatient services, casualty services, operating theatres, laboratories, medical schools (for university hospitals) and out-reach medical camps. Healthcare professionals are required to support these different units hence the need to be constantly mobile in undertaking their duties. These duties require that they frequently consult colleagues, receive handover from previous duty staff or share information on previous work undertaken. Successful use and adoption of handheld devices such as PC tablets, PDAs and smartphones integrated to health information systems can minimize the physical mobility. Information sharing using M-health solutions in complex and diverse healthcare settings draw focus beyond the spatiality gains to the coordination of the teams, processes and shared artefacts in healthcare. CSCW research abounds with various concepts that can be useful in characterizing mobility and communication amongst collaborating health workers. Design for mobile health solutions, therefore, provides an opportunity to further ground theoretical frameworks from exemplary studies on health information systems. The overall objective of the study is to propose design suggestions that target successful information sharing in the deployment and use of M-health solutions. To achieve this objective, the thesis investigates and analyses factors influencing the use and adoption of M-health solutions. A qualitative literature review is used in the study to explore significant factors in the acceptance and use of health information systems. A questionnaire developed from these key factors is used to determine the perceptions of healthcare professionals on M-health solutions based on related literature and on a field study. Finally, the findings are discussed using concepts from CSCW literature namely, mobility, common information spaces, temporality and cognitive and coordinative artefacts. As a result, a conceptual model integrating constructs from the Technology acceptance model (TAM) and IS Success model was developed that can be useful in investigating perceptions in the use of M-health solutions. Design suggestions were proposed for the development of future M-health solutions that aim to achieve successful information sharing amongst healthcare professionals.