Thesis (Ph. D.)--Northwestern University, 1977. / Also issued in print.

Thesis (Ph. D.)--Northwestern University, 1977. / eContent provider-neutral record in process. Description based on print version record.

Introduction: There is an increased acceptance and demand for online and mobile health (mHealth) interventions to support physical and mental health problems. However, the uptake and engagement of these interventions is relatively low and the evidence base for these interventions requires continual updating in line with technological advances. A systematic review was conducted, focusing on anxiety and depression, to explore the existing evidence base of both physical health and mental health mobile applications. The first research paper explores the acceptability of mHealth interventions for both mental health and physical health problems. The final research paper explores use and strategies when searching for mental health information online. Additionally, perceived quality, sentiment and barriers to online health information was explored. Methods: Studies were identified by searching for articles published between January 2008 and January 2016. Databases included: PsycINFO, MEDLINE, CINAHL PLUS and the Cochrane Central Register of Controlled Trials for 2016. In the research articles, 218 people completed an online survey in January 2016 exploring, online health seeking for mental health and physical health problems, and acceptability of mHealth interventions. Sentiment of online health resources was explored by extracting 432 individual tweets from Twitter. Results: The systematic review revealed twenty-seven studies for inclusion; 10 with a physical health focus and 17 with a mental health focus. Targeted depression applications have the superior evidence base; however, no firm conclusions can be made regarding interventions that targeted physical health, or those measuring anxiety. The first research paper found that face-to-face therapy would more likely meet expectations for treatment of both physical and mental health problems compared to mHealth interventions. Computerised interventions were more likely to meet expectations than mobile applications. Expectations of treatment were higher for the treatment of mental health problems than physical health problems. The second research paper found that a large proportion of the public use the internet to search for information on mental health, with half citing it as their primary source for mental health information. The online survey found that the quality of mental health information available on the internet was rated favourably, compared to mobile applications. Overall, the sentiment towards specific online mental health resources was generally positive. Conclusions: Research into online and mHealth interventions has developed considerably in recent years in line with advances in technology. These interventions have the potential to be an effective treatment of common mental health problems. The systematic review highlighted that depression applications are more established and effective than applications targeting anxiety. The first research paper suggests that mHealth interventions fall short of public expectations for treatment of health problems. The final research paper reflects that the perceived quality of online mental health information is rated favourably. However, many barriers still limit uptake. Future research could focus on continually developing and evaluating evidence based online and mHealth interventions and the outcome of this study suggests that incorporating them more widely into existing care systems, alongside face to face interventions could increase the public’s confidence in these interventions.

abstract: Advances in miniaturized sensors and wireless technologies have enabled mobile health systems for efficient healthcare. A mobile health system assists the physician to monitor the patient's progress remotely and provide quick feedbacks and suggestions in case of emergencies, which reduces the cost of healthcare without the expense of hospitalization. This work involves development of an innovative mobile health system with adaptive biofeedback mechanism and demonstrates the importance of biofeedback in accurate measurements of physiological parameters to facilitate the diagnosis in mobile health systems. Resting Metabolic Rate (RMR) assessment, a key aspect in the treatment of diet related health problems is considered as a model to demonstrate the importance of adaptive biofeedback in mobile health. A breathing biofeedback mechanism has been implemented with digital signal processing techniques for real-time visual and musical guidance to accurately measure the RMR. The effects of adaptive biofeedback with musical and visual guidance were assessed on 22 healthy subjects (12 men, 10 women). Eight RMR measurements were taken for each subject on different days under same conditions. It was observed the subjects unconsciously followed breathing biofeedback, yielding consistent and accurate measurements for the diagnosis. The coefficient of variation of the measured metabolic parameters decreased significantly (p < 0.05) for 20 subjects out of 22 subjects. / Dissertation/Thesis / M.S. Electrical Engineering 2012

abstract: Monitoring vital physiological signals, such as heart rate, blood pressure and breathing pattern, are basic requirements in the diagnosis and management of various diseases. Traditionally, these signals are measured only in hospital and clinical settings. An important recent trend is the development of portable devices for tracking these physiological signals non-invasively by using optical methods. These portable devices, when combined with cell phones, tablets or other mobile devices, provide a new opportunity for everyone to monitor one’s vital signs out of clinic. This thesis work develops camera-based systems and algorithms to monitor several physiological waveforms and parameters, without having to bring the sensors in contact with a subject. Based on skin color change, photoplethysmogram (PPG) waveform is recorded, from which heart rate and pulse transit time are obtained. Using a dual-wavelength illumination and triggered camera control system, blood oxygen saturation level is captured. By monitoring shoulder movement using differential imaging processing method, respiratory information is acquired, including breathing rate and breathing volume. Ballistocardiogram (BCG) is obtained based on facial feature detection and motion tracking. Blood pressure is further calculated from simultaneously recorded PPG and BCG, based on the time difference between these two waveforms. The developed methods have been validated by comparisons against reference devices and through pilot studies. All of the aforementioned measurements are conducted without any physical contact between sensors and subjects. The work presented herein provides alternative solutions to track one’s health and wellness under normal living condition. / Dissertation/Thesis / Doctoral Dissertation Electrical Engineering 2016

abstract: Mobile apps have improved human lifestyle in various aspects ranging from instant messaging to tele-health. In the current app development paradigm, apps are being developed individually and agnostic of each other. The goal of this thesis is to allow a new world where multiple apps communicate with each other to achieve synergistic benefits. To enable integration between apps, manual communication between developers is needed, which can be problematic on many levels. In order to promote app integration, a systematic approach towards data sharing between multiple apps is essential. However, current approaches to app integration require large code modifications to reap the benefits of shared data such as requiring developers to provide APIs or use large, invasive middlewares. In this thesis, a data sharing framework was developed providing a non-invasive interface between mobile apps for data sharing and integration. A separate app acts as a registry to allow apps to register database tables to be shared and query this information. Two health monitoring apps were developed to evaluate the sharing framework and different methods of data integration between apps to promote synergistic feedback. The health monitoring apps have shown non-invasive solutions can provide data sharing functionality without large code modifications and manual communication between developers. / Dissertation/Thesis / M.S. Computer Science 2014

O Sistema Nacional de Saúde (SNS) em Moçambique sofreu uma significativa degradação e fragilização, resultado em parte da guerra civil ocorrida por cerca de 20 anos, o país continua debatendo com problemas de fome, nudez e inúmeros outros socioeconômicos, que direta ou indiretamente afetam a saúde das populações, fato evidente nos dias de hoje, traduzido pelo difícil acesso a saúde das populações residentes em áreas rurais e urbanas. A cobertura no atendimento da saúde para as populações em cerca de 70%, residente na área rural, sob baixa renda, alto índice de analfabetismo, se caracteriza por deficiente no respeite a quantidade das unidades sanitárias disponíveis, e na falta de recursos humanos capazes de cobrir a demanda do País. A pesquisa que se propõe objetiva na busca de uma solução em curto prazo, tem por objeto levar a saúde às das comunidades rurais em áreas longínquas de difícil acesso ou com carência de unidades sanitárias, a partir de uma proposta Modelo de Unidade Sanitária Móvel, capaz de oferecer à população serviços de atendimentos básicos em cuidados primários e de prevenção. O modelo será definido com base nos resultados da análise feita ao SNS, tendo como pano de fundo: a população, doenças, indicadores social/saúde, recursos humanos, e impactos socioeconômicos. Que o resultado, além do proposto, seja aplicável no desenvolvimento do país, na melhoria e benefício das comunidades atendidas, e que partindo das diretrizes esboçadas, sirva de base para futuros projetos idêntica. O método de pesquisa que se pretende utilizar basear-se-á em levantamento bibliográfico e estudo caso a caso, com entrevistas a profissional e organizações que estejam atualmente envolvidas em ações idênticas, bem como a visita e eventual acompanhamento de expedições feitas pelas suas unidades. / The National Health Service (NHS) in Mozambique has suffered a significant degradation and weakening, in part as a result of the civil war tooked place for about 20 years, the country still struggling with problems of hunger, nakedness and numerous other socioeconomic factors, that directly or indirectly affect the health of populations, a fact evident today, translated by difficult access to the health of people living in rural and urban areas. The coverage in health care to populations, in about 70% residing in rural areas in low income, high illiteracy rate, is characterized by deficient in respecting the amount of available health facilities, and lack of human resources capable of cover the demand of the country. The research aims to propose a research of a short term solution, in order to bring health in rural communities in remote areas of difficult access or lack of health facilities, from a proposed Model of Mobile Health Unit capable of providing basic care services in primary care, and prevention to the population. The model will be defined on the results of analysis done on the NHS, having as backdrop: the population, disease, social indicators / health, human resources, and socio-economic impacts. As a result of the proposed addition, is applicable in the development of the country to improve and benefit the communities served, and using the guidelines outlined, serve for future similar projects. The research method intended to be used, will be based on a survey of publications and case studies, interviews with professionals and organizations currently involved in similar actions, as well as the visit and any follow-up mailings made by their units.

Many health care providers aim to become more patient-centered, and developing mobile health applications for patients might help achieve this. In the light of this, this thesis explores if the progressive web application (PWA) concept is suitable for mobile health applications. It is investigated by developing a PWA intended to be used to gather health care patients’ self assessments. The work follows the double diamond design process with: a discover phase containing a literature study, interviews with experts, and partaking in a workshop; a define phase where system requirements are specified; a develop phase with lo- and mid-fi prototypes as well as usability tests with six test users; and a deliver phase where the application is implemented using Polymer 2.0 and web components. To furthermore assess the patients satisfaction of a PWA, an evaluation phase is conducted where eleven test users tries it during five consecutive evenings and answers a survey at the end. The general opinions were that they thought it worked good and was easy to use, indicating that a PWA can be suitable for this purpose. Following this and discussions of findings, we suggest guidelines for how to design and implement a PWA for similar projects. However, the developed PWA was due to shortage of time not completely finished and the test users support for PWA features were rather limited, so future investigation is recommended to determine if PWAs are suitability in this context.

Technology has taken over tasks that were originally carried out by professionals in all different kinds of industries and sectors ranging from self-check in at airports to money transfer via mobile devices. In the healthcare sector the internet has become one main information resource for health-related issues and with the introduction of mobile devices such as smartphones the mHealth market has evolved. With help of mHealth applications (mHealth apps) patients can actively participate in maintaining their health and take over tasks usually fulfilled by health professionals. Despite the advantages of mHealth apps in practice, the download numbers are decreasing and the academic world has not paid much attention to the end-users point of view. The purpose of this paper is to identify factors influencing end-users in their intention to use mHealth apps. In order to answer this research question a quantitative research design has been chosen. The data is collected with help of an online self-completion questionnaire and statistical analysis with the software SPSS. Time and Perceived Usefulness were two out of five factors that had an influence on the end-users intention to use mHealth apps. A key finding of this study is that the mHealth app market is still in its early stage and end-users lack knowledge about it. This paper contributes to theory as well as to practice by providing new research directions for the academic world and insights for app developers and marketers to adapt their marketing strategies in order to meet the customers’ needs.

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado. / In this article, a technological solution is proposed to identify and reduce the level of mental stress of a person through a wearable device. The proposal identifies a physiological variable: Heart rate, through the integration between a wearable and a mobile application through text recognition using the back camera of a smartphone. As part of the process, the technological solution shows a list of guidelines depending on the level of stress obtained in a given time. Once completed, it can be measured again in order to confirm the evolution of your stress level. This proposal allows the patient to keep his stress level under control in an effective and accessible way in real time. The proposal consists of four phases: 1. Collection of parameters through the wearable; 2. Data reception by the mobile application; 3. Data storage in a cloud environment and 4. Data collection and processing; this last phase is divided into 4 sub-phases: 4.1. Stress level analysis, 4.2. Recommendations to decrease the level obtained, 4.3. Comparison between measurements and 4.4. Measurement history per day. The proposal was validated in a workplace with people from 20 to 35 years old located in Lima, Peru. Preliminary results showed that 80% of patients managed to reduce their stress level with the proposed solution. / Revisión por pares