Thurstonhong3772

Background Mobile app-assisted self-care interventions are emerging promising tools to support self-care of patients with chronic diseases such as type 2 diabetes and hypertension. The effectiveness of such interventions requires further exploration for more supporting evidence. Objective A systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted to examine the effectiveness of mobile app-assisted self-care interventions developed for type 2 diabetes and/or hypertension in improving patient outcomes. Methods We followed the Cochrane Collaboration guidelines and searched Medline, Cochrane Library, Embase, and CINAHL Plus for relevant studies published between January 2007 and January 2019. Primary outcomes included changes in hemoglobin A1c (HbA1c) levels, systolic blood pressure (SBP), and diastolic blood pressure (DBP). Changes in other clinical-, behavioral-, knowledge-, and psychosocial-related outcomes were included as secondary outcomes. Primary outcomes and objective seclood glucose levels and waist circumference. Forty-two secondary outcomes were narratively synthesized, and mixed results were found. Conclusions Mobile app-assisted self-care interventions can be effective tools for managing blood glucose and blood pressure, likely because their use facilitates remote management of health issues and data, provision of personalized self-care recommendations, patient-care provider communication, and decision making. More studies are required to further determine which combinations of intervention features are most effective in improving the control of the diseases. Moreover, evidence regarding the effects of these interventions on the behavioral, knowledge, and psychosocial outcomes of patients is still scarce, which warrants further examination.Background Poor adherence to inhaled corticosteroid (ICS) medications for children with high-risk asthma is a well-documented and poorly understood problem with a disproportionate prevalence and impact on urban minority children. Financial incentives have been shown as a compelling method to engage a high-risk asthma population, but whether and how adherence can be maintained and lead to sustained high adherence trajectories is unknown. Objective To determine the marginal effects of a financial incentive-based ICS adherence intervention on adherence, healthcare system use, and costs in a prospective cohort of child-caregiver dyads. Methods Participants include 125 children aged 5-12 years who have had at least two hospitalizations or one hospitalization and one emergency room visit for asthma in the prior year and their caregivers. All participants have an electronic inhaler sensor that is linked to a smartphone app to track medication use for 7 months. After one month of observation, participants are randomized to one of three possible arms for a 3-month experiment. Participants in arm 1 receive daily text message reminders, feedback, and nominal gain-framed financial incentives; those in arm 2 receive daily text message reminders and feedback only and those in arm 3 receive no reminders, feedback, or incentives. All participants are then observed for an additional 3 months with no reminders, feedback, or incentives to assess for sustained effects. Results Study enrollment began in September 2019. Estimated primary completion date is June of 2022 and analyses will be completed by June of 2023. Conclusions The present study will provide data on whether a financial incentive-based mobile-health intervention for promoting ICS use is efficacious in high-risk asthma patients over time. Clinicaltrial Clinicaltrial.gov NCT03907410; https//clinicaltrials.gov/ct2/show/NCT03907410.Background Physical activity can prolong the ability of older adults to live independently. Home-based exercises can help achieve the recommended levels. A blended intervention was developed to support older adults in performing home-based exercises. AZD5991 supplier A tablet and a personal coach were provided to facilitate the self-regulation of exercise behavior. Objective In line with the Medical Research Council Framework, the aim of the study was to carry out a process evaluation of the blended intervention. The objectives were a) to assess the long-term usability of the tablet used in the blended intervention and b) to explore how the tablet, in conjunction with a personal coach, supported older adults in performing home-based exercises. Methods The process evaluation was conducted with a mixed-methods approach. At baseline, older adults participating in the blended intervention were asked to fill out a questionnaire about their general experience with ICT devices and rate their own skill level. After 6 months participaon a 5-point scale respectively. The analysis of the interviews show that participants felt that the tablet supported action planning, behavior execution and self-monitoring. On the other hand, especially during the first few months, the personal coach had added value during the goal setting, behavior execution and evaluation phases of self-regulation. Conclusions The results of the process evaluation have shown older adults that participated in the study are positive about a blended intervention that was designed to support them in performing home-based exercises. Participants reported that the tablet helped them to perform the exercises better, more frequent and safely. It supported them in various phases of self-regulation. The availability of personal coach was nevertheless crucial. To support physical activity in older adults a blended approach is promising.Background Intensive lifestyle interventions are effective in reducing the risk of type 2 diabetes, but the implementation of findings from landmark studies is expensive and time consuming. The availability of digital lifestyle interventions is increasing, but evidence of their effectiveness is limited. Objective This randomized controlled trial (RCT) aimed to test the feasibility of a web-based diabetes prevention program (DPP) with step-dependent feedback messages versus a standard web-based DPP in people with pre-diabetes. Methods We employed a 2-arm, parallel, single-blind RCT for people at high risk of developing diabetes. Patients with a hemoglobin A1c (HbA1c) level of 39-47 mmol/mol were recruited from 21 general practices in London. The intervention integrated a smartphone app delivering a web-based DPP course with SMS texts incorporating motivational interviewing techniques and step-dependent feedback messages delivered via a wearable device over 12 months. The control group received the wearable technology and access to the e-DDP but not the SMS texts.