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Tag: mhealth
01/03/2023

Effect of Mobile Phone App–Based Interventions on Quality of Life and Psychological Symptoms Among Adult Cancer Survivors: Systematic Review and Meta-analysis of Randomized Controlled Trials

Qin M, Chen B, Sun S, Liu X.Effect of Mobile Phone App–Based Interventions on Quality of Life and Psychological Symptoms Among Adult Cancer Survivors: Systematic Review and Meta-analysis of Randomized Controlled Trials. J Med Internet Res 2022;24(12):e39799 DOI: 10.2196/39799

A systematic review and meta-analysis was conducted to investigate the effectiveness of mobile phone app interventions on quality of life (QOL) and psychological outcomes in adult cancer patients. Researchers identified randomized controlled trial studies evaluating apps that targeted adults with cancer and QOL or psychological symptoms. In total, 30 randomized controlled trials with a total of 5,353 patients were included in the meta-analysis. App interventions included health education, physician-patient communication, or data management regarding patient self-monitoring behaviors. On average, interventions were conducted over 2.8 months. Compared with standard care, app interventions significantly improved QOL (Standardized Mean Difference (SMD)=0.39, p<.001) and self-efficacy (SMD=0.15, p=.03) and reduced anxiety (SMD=0.64, p<.001), depression (SMD=-0.33, p=.009), and distress (SMD=-0.34, p=.01) symptoms. Subgroup analyses were also conducted for intervention duration, type of cancer, theoretical approach, treatment category, and intervention delivery (interactive 2-way communication format versus 1-way communication format). Short-term (<3 months) interventions were found to have higher effectiveness compared to longer term interventions for QOL, anxiety and depression. However, given that only 9 studies were longer than 3 months, there is a need for further research on the long-term effects of these app interventions. Apps that included physician-patient communication and that were based on cognitive behavioral therapy were most effective for improving QOL and psychological outcomes. Overall, results provide evidence for the effectiveness of mobile phone app interventions on QOL and psychological outcomes, however caution is needed in the over-interpretation of findings due to high heterogeneity across the studies.

12/05/2022

A Mobile Intervention to Link Young Female Entertainment Workers in Cambodia to Health and Gender-Based Violence Services: Randomized Controlled Trial

Brody C, Chhoun P, Tuot S, Fehrenbacher A, Moran A, Swendeman D, Yi S. A Mobile Intervention to Link Young Female Entertainment Workers in Cambodia to Health and Gender-Based Violence Services: Randomized Controlled Trial. J Med Internet Res 2022;24(1):e27696 DOI: 10.2196/27696

This study evaluated the efficacy of the Mobile Link intervention to improve female entertainment workers’ (FEW) health through engagement and connection to HIV, sexual and reproductive health, and gender-based violence services. In Cambodia, FEWs are employed at karaoke bars, restaurants, bars, and massage parlors and many exchange sex to supplement their income. Researchers conducted a randomized controlled trial in the capital city and 3 other regions in Cambodia with high numbers of FEWs and HIV prevalence. Eligible participants were aged 18-30 years, working as a FEW, sexually active, and owned a mobile phone. Participants were randomized to the Mobile Link intervention arm (n=218) or to the control arm (standard care; n=170). For 60 weeks, participants in the Mobile Link arm received automated twice-weekly text messages and voice messages with health information and direct links to community outreach workers. Outcomes included self-reported HIV and sexually transmitted infection (STI) testing, condom use, and contraceptive use at baseline and 6- and 12-month follow up. Results showed significant improvements in HIV and STI testing, condom use, and contraceptive use in both arms. The Mobile Link intervention was effective in connecting FEWs with outreach workers – contact increased by 61% in the intervention arm compared to a decrease of 30% in the control arm. Additionally, participants in the intervention arm reported significant reductions in forced drinking behavior at work from supervisors or peers compared to those in the control arm. Although there were no differences in the main outcomes, the Mobile Link intervention may be helpful in linking to outreach workers and could be potentially implemented among other populations in Cambodia, perhaps as an adjunct to standard care. Future research may consider using longer-term messaging to increase access to services and impact health outcomes.

09/19/2022

The Efficacy of “Foundations,” a Digital Mental Health App to Improve Mental Well-being During COVID-19: Proof-of-Principle Randomized Controlled Trial

Catuara-Solarz S, Skorulski B, Estella-Aguerri I, Avella-Garcia C, Shepherd S, Stott E, Hemmings N, Ruiz de Villa A, Schulze L, Dix S. The Efficacy of “Foundations,” a Digital Mental Health App to Improve Mental Well-being During COVID-19: Proof-of-Principle Randomized Controlled Trial. JMIR Mhealth Uhealth 2022;10(7):e30976 DOI: 10.2196/30976

This study aimed to evaluate the efficacy of a mobile app, “Foundations”, to reduce self-reported symptoms of anxiety and stress in a randomized control trial during the COVID-19 pandemic in the United Kingdom. Adults (N=136) with mild to severe anxiety and moderate to high levels of perceived stress were randomly assigned to four weeks of the Foundations app or a waitlist control. The Foundations app includes cognitive behavioral therapy interventions and psychoeducation aimed at reducing stress and promoting mental well-being. Activities consist of reading articles, journaling, meditation, and relaxation. Resilience, anxiety, well-being, and sleep were assessed at baseline, weeks 2 and 4. Perceived stress was assessed weekly. The intervention group (n=62) showed significant improvement in anxiety (p=0.04), resilience (p<0.001), sleep (p=0.01), and mental well-being (p=0.02) compared to the control group (n=74). This improvement was observed within 2 weeks of the intervention and sustained at week 4. There was no significant difference in perceived stress between the intervention and control groups (p=0.20). Overall, this study provides a proof of principle that the Foundations app may improve mental well-being, anxiety, resilience, and sleep. Future research should evaluate the long-term effects of the Foundations app and the scalability and cost-effectiveness of the intervention. The passive nature of the control group in this study does not rule out placebo effects in the digital intervention group and future research would benefit from an active control condition.

07/05/2022

The EMPOWER blended digital intervention for relapse prevention in schizophrenia: a feasibility cluster randomized controlled trial in Scotland and Australia

Gumley AI, Bradstreet S, Ainsworth J, Allan S, Alvarez-Jimenez M, Aucott L, Birchwood M, Briggs A, Bucci S, Cotton SM, Engel L, French P, Lederman R, Lewis S, Machin M, MacLennan G, McLeod H, McMeekin N, Mihalopoulos C, Gleeson J (2022). The EMPOWER blended digital intervention for relapse prevention in schizophrenia: a feasibility cluster randomised controlled trial in Scotland and Australia. The Lancet. Psychiatry, 9(6), 477–486. https://doi.org/10.1016/S2215-0366(22)00103-1

The study used a randomized controlled study design to evaluate feasibility of a digital intervention for relapse prevention in schizophrenia, Monitoring to Prevent relapse in psychosis and prOmote Well-being, Engagement, and Recovery (EMPOWER). Eight community mental health service (CMHS) sites in Glasgow and Melbourne were randomized to EMPOWER or treatment as usual. Participants older than 16 years of age, who had a schizophrenia diagnosis, had contact with CMHS, and had a relapse in the past two years, were recruited (N=73). EMPOWER is a blended peer and clinician support smartphone app that allows people to monitor their wellbeing and warning signs of schizophrenia relapse (i.e., a return to active schizophrenia symptoms) over a maximum of 12 months. The app includes messages to enhance self-management and autonomy and visual charts to observe changes in self-reported well-being over time. Researchers assessed feasibility, acceptability, usability, and safety through in-person interviews at the end of 12-months. Results demonstrated high rates of engagement with the app and participants reported using the app on a weekly to daily basis. Participants reported a moderate willingness (mean of 2.45 on scale of 1-4) to share their data with caregivers and staff. Overall, participants rated the app as interesting to use, easy to learn, and that the content was well written and credible. Fear of relapse was lower in the EMPOWER group than in the treatment as usual group (mean difference of -7.53 points (95% CI: 14.45 to 0.60). Results suggest the promise of EMPOWER and a next step to evaluate its effectiveness and cost-effectiveness in further research.

05/09/2022

FOCUS mHealth Intervention for Veterans with Serious Mental Illness in an Outpatient Department of Veterans Affairs Setting: Feasibility, Acceptability, and Usability Study

Buck B, Nguyen J, Porter S, Ben-Zeev D, Reger GM. FOCUS mHealth Intervention for Veterans With Serious Mental Illness in an Outpatient Department of Veterans Affairs Setting: Feasibility, Acceptability, and Usability Study. JMIR Ment Health 2022;9(1):e26049. doi: 10.2196/26049

This study evaluates the feasibility, acceptability, and preliminary effectiveness of a mobile health intervention for veterans with serious mental illnesses (SMIs) in a VA outpatient care. Seventeen veterans with SMIs participated in a one-month pilot trial of FOCUS. FOCUS consists of a mobile app, a clinician dashboard, and a mHealth support specialist. The app provides brief self-management interventions based on the user’s responses to an ecological momentary assessment (EMA). Interventions include strategies to cope with auditory hallucinations, mood, sleep, social functioning, and medication use. A mHealth support specialist tracks and gives technical support for participants’ use of FOCUS. The specialist also gives weekly updates to the mental health treatment team on each veteran’s use of FOCUS and reported symptoms and functioning. Researchers collected data on mental health symptoms and functional recovery, as well as qualitative feedback on the acceptability of FOCUS. On average, participants completed 85 EMAs and used FOCUS on 19.29 out of 30 access days. Overall, participants reported the intervention as highly acceptable; 94% would recommend FOCUS to a friend, and 88% felt satisfied. Based on qualitative interviews, participants found FOCUS complements their VA services and suggested possible subgroups to target (i.e., combat veterans). During the pilot, participants reported statistically non-significant improvements in recovery, auditory hallucinations, and quality of life. The study administered surveys to clinicians who had patients participating in FOCUS to assess feasibility and acceptability. Based on this data, clinicians found the mHealth updates useful for informing their care. FOCUS appears to be feasible, acceptable, and useful for veterans with SMIs; future research could examine specific implementation strategies in the VA, as well as replicate the effectiveness of FOCUS with a larger sample.

05/01/2022

Group Lifestyle Intervention With Mobile Health for Young Adults With Serious Mental Illness: A Randomized Controlled Trial

Aschbrenner KA, Naslund JA, Gorin AA, Mueser KT, Browne J, Wolfe RS, Xie H, & Bartels SJ. (2022). Group Lifestyle Intervention With Mobile Health for Young Adults With Serious Mental Illness: A Randomized Controlled Trial. Psychiatric Services (Washington, D.C.), 73(2), 141–148. https://doi.org/10.1176/appi.ps.202100047

A study tested the effectiveness of PeerFIT, a group lifestyle intervention enhanced with mobile health for young adults with serious mental illness who were overweight or obese. PeerFIT is a 12-month, manualized group lifestyle intervention that includes weight loss and physical activity goals and a curriculum delivered by lifestyle coaches. One hundred fifty participants receiving services in partner community mental health centers were randomly assigned to the PeerFIT intervention or an active control condition (one-on-one basic education coaching and activity tracking). Eligible participants were 18-35 years of age, with serious mental illness and a body mass index at least 25kg/m2. PeerFIT had a 6-month phase of twice-weekly group meetings, followed by a 6-month maintenance phase of weekly exercise sessions. The intervention also used a private Facebook group where participants can access information, post content that support healthy lifestyles, and receive text message reminders and encouragement from the coach. Data was collected on cardiovascular disease (CVD) risk reduction, cardiorespiratory fitness (CRF), and weight loss at 6- and 12-month follow-up. The results showed no significant differences between the PeerFIT and control groups in reduced CVD risk, CRF, or weight loss. Participants in both arms achieved clinically significant CVD risk reduction, weight loss, and CRF between baseline and follow-ups. Although PeerFIT was not superior to one-on-one coaching in achieving reduced CVD risk, mobile Health coaching may be a more scalable innovation than in-person group interventions for young adults in routine mental health care settings.

02/21/2022

Use of mobile apps for self-care in people with Parkinson disease: Systematic review

Lee J, Yeom I, Chung ML, Kim Y, Yoo S, Kim E. (2022). Use of mobile apps for self-care in people with Parkinson disease: Systematic review. JMIR mHealth and uHealth, 10(1), e33944. https://doi.org/10.2196/33944

A systematic review was conducted to explore the features and characteristics of mobile apps for self-care among people with Parkinson disease. Self-care includes health maintenance, symptoms tracking and monitoring, and symptom management. Seventeen studies were identified in the review, including 3 randomized controlled trials and 14 observational and quasi-experimental studies. Most of the mobile apps focused on symptom monitoring, especially motor symptoms. Motor symptoms were measured through smartphone sensors, wearable devices, and task performance. Many studies focused on clinical symptoms assessment for Parkinson disease and there is a lack of studies on symptom management. Future research is needed for people with Parkinson disease on self-care management and maintenance based on symptom monitoring.

01/31/2022

Mobile phone-based interventions for mental health: A systematic meta-review of 14 meta-analyses of randomized controlled trials

Goldberg SB, Lam SU, Simonsson O, Torous J, Sun S (2022) Mobile phone-based interventions for mental health: A systematic meta-review of 14 meta-analyses of randomized controlled trials. PLOS Digit Health 1(1): e0000002. https://doi.org/10.1371/journal.pdig.0000002

Researchers conducted a systematic review of meta-analyses to synthesize evidence for effectiveness of mobile phone-based mental health interventions evaluated in randomized controlled trials. The study aimed to clarify the strength of evidence across different participants, interventions, comparisons, and outcomes. Studies that report an effect size from a meta-analysis related to mobile phone-based interventions, on any mental health outcome, and based on at least four randomized controlled trials were included. The review summarized the results from 14 meta-analyses with a total of 145 randomized controlled trials representing 47,940 participants. Thirty-four effect sizes were identified and evaluated on criteria related to strength of evidence. Eight effect sizes showed promising evidence (n>1000, p<10-6) for mobile apps to improve psychological symptoms and quality of life and text message-based interventions for smoking cessation. Four effect sizes provided suggestive evidence (n>1000, p<10-3), 14 provided weak evidence (n>1000, p<0.05), and eight were non-significant. The magnitude of effects decreased as comparison conditions were more active. Only one study tested moderators as predictors, including study design and aspects of the intervention; however, none significantly impacted treatment effects. Overall, the results indicate that mobile phone-based interventions have potential to promote mental health.

12/15/2021

Digital Interventions May Aid in Reducing Depression Symptoms

Article Excerpt: Digital interventions accessed through a computer or smartphone were effective at reducing symptoms of depression, according to a meta-analysis published by the American Psychological Association. The COVID-19 pandemic exacerbated the country’s mental health crisis and telehealth played a significant role in addressing the increased demand for care. Clinicians also utilized asynchronous digital interventions to help patients improve their mental health. These interventions consisted of patients using an online program, website, or application to individually participate in modules or lessons. Unlike videoconferencing and audio-only telehealth, digital interventions do not include one-on-one synchronous appointments between patients and providers.

Full Article: https://tinyurl.com/2p8w762y

Article Source: mHealth Intelligence