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A Qualitative Study Exploring Stakeholder Perceptions of Video Directly Observed Therapy for Monitoring Tuberculosis Treatment in the US-Mexico Border Region

Posted on Jul 28, 2016 in Original Article | 0 comments

María Luisa Zúñiga, PhD1, Kelly Collins, PhD2, Fátima Muñoz, MD, MPH2, Kathleen Moser, MD, MPH3, Gudelia Rangel, PhD4, Jazmine Cuevas-Mota, MPH2, Maureen Clark, BA2, Jose Luis Burgos, MD, MPH2, Richard S. Garfein, PhD, MPH2

1San Diego State University, School of Social Work, 5500 Campanile Drive, San Diego, CA, USA; 2Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, USA; 3San Diego County Health and Human Services Agency, San Diego, CA, USA; 4Comisión de Salud Fronteriza, Sección México-Secretaria de Salud, Tijuana, Baja California, México

Corresponding Author:

Journal MTM 5:2:12–23, 2016


Background: Tuberculosis (TB) incidence in the U.S.-Mexico border region exceeds both countries’ national rates. The four U.S. states bordering Mexico account for nearly 40% of total U.S. TB cases. TB treatment monitoring using directly observed therapy (DOT) is a globally-accepted practice; however, it is resource intensive for providers and patients.

Aims: To determine whether Video DOT (VDOT)—a process whereby patients record themselves taking their medication by mobile phone and sending the videos to their TB care provider for observation—could be used to remotely monitor TB treatment adherence.

Methods: We conducted five focus groups with TB patients and four with TB care providers in San Diego, California, U.S. and Tijuana, B.C., Mexico.

Results: VDOT consistently received broad support: U.S. patients valued greater autonomy and Mexican patients valued improved privacy. Groups agreed technology would not be a barrier, but emphasized need for adequate patient training.

Conclusion: Patients and providers in both countries found VDOT conceptually feasible and acceptable.

Mobile and Wearable Device Features that Matter in Promoting Physical Activity

Posted on Jul 28, 2016 in Original Article | 0 comments

Julie B. Wang, PhD, MPH1,2,3, Janine K. Cataldo, RN, PhD3, Guadalupe X. Ayala, PhD, MPH2, Loki Natarajan, PhD1, Lisa A. Cadmus-Bertram, PhD4, Martha M. White, MS1, Hala Madanat, PhD2, Jeanne F. Nichols, PhD, FACSM5, John P. Pierce, PhD1

1Moores Cancer Center, University of California, San Diego, La Jolla, California, USA; 2Graduate School of Public Health, San Diego State University, San Diego, California, USA; 3Cardiovascular Research Institute, University of California, San Francisco, San Francisco, California, USA; 4Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin; 5Center for Wireless Population Health Systems, University of California, San Diego, La Jolla, California, USA

Corresponding Author:

Journal MTM 5:2:2–11, 2016


Background: As wearable sensors/devices become increasingly popular to promote physical activity (PA), research is needed to examine how and which components of these devices people use to increase their PA levels.

Aims: (1) To assess usability and level of engagement with the Fitbit One and daily SMS-based prompts in a 6-week PA intervention, and (2) to examine whether use/ level of engagement with specific intervention components were associated with PA change.

Methods: Data were analyzed from a randomized controlled trial that compared (1) a wearable sensor/ device (Fitbit One) plus SMS-based PA prompts, and (2) Fitbit One only, among overweight/obese adults (N=67). We calculated average scores from Likert-type response items that assessed usability and level of engagement with device features (e.g., tracker, website, mobile app, and SMS-based prompts), and assessed whether such factors were associated with change in steps/day (using Actigraph GT3X+).

Results: Participants reported the Fitbit One was easy to use and the tracker helped to be more active. Those who used the Fitbit mobile app (36%) vs. those who did not (64%) had an increase in steps at 6-week follow-up, even after adjusting for previous web/app use: +545 steps/ day (SE=265) vs. −28 steps/ day (SE=242) (p=.04).

Conclusions: Level of engagement with the Fitbit One, particularly the mobile app, was associated with increased steps. Mobile apps can instantly display summaries of PA performance and could optimize self-regulation to activate change. More research is needed to determine whether such modalities might be cost-effective in future intervention research and practice.

An integrated mHealth model for type 2 diabetes patients using mobile tablet devices

Posted on Jul 28, 2016 in Original Article | 0 comments

Sora Park, PhD1, Sally Burford, PhD1, Leif Hanlen, PhD2, Paresh Dawda, MBBS/DRCOG3, Paul Dugdale, PhD/FAFPHM4, Christopher Nolan, MBBS/PhD5, John Burns, Adjunct Professor6

1News & Media Research Centre, University of Canberra, ACT, Australia; 2Data61, University of Canberra, Australian National University, ACT, Australia; 3Ochre Health Medical Centre, ACT, Australia; 4College of Medicine, Biology & Environment, Australian National University, ACT, Australia; 5College of Medicine, Biology & Environment, Australian National University, Canberra Hospital, ACT, Australia; 6University of Canberra, ACT, Australia

Corresponding Author:

Journal MTM 5:2:24–32, 2016

doi: 10.7309/jmtm.5.2.4

Background: Ease of use, proximity to the user and various health maintenance applications enable mobile tablet devices to improve patient self-management. With mobile phones becoming prevalent, various mobile health (mHealth) programs have been devised, to improve patient care and strengthen healthcare systems.

Aims: This study explored how mHealth programs can be developed for type 2 diabetes patients through a co-design participatory workshop between practitioners and researchers. The aim was to design a mHealth pilot program from the input.

Methods: A co-design workshop was conducted with 15 participants, including general practitioners, specialists, nurses and a multidisciplinary research team. Participants generated 31 statements in response to a trigger question and engaged in a structured discussion. Thematic cluster analysis was conducted on the statements and discussions.

Results: Through the analysis, patients’ self-management and health system integration emerged as the main topics. Further analysis revealed that there were two distinct areas of patient self-management; ‘compelled’ and ‘empowered’.

Conclusion: With the results, a loose-knit mHealth pilot program was developed wherein patients with various levels of conditions and digital skills could be incorporated. In order to encourage sustainable changes, practitioners proposed that mobile devices must be situated in the patients’ everyday settings and that digital training should be provided.

Scope of Mobile Phones in Mental Health Care in Low Resource Settings

Posted on Jul 28, 2016 in Original Article | 0 comments

M Sood, Additional Prof.1, RK Chadda, Prof.1, K Sinha Deb, Assistant Prof.1, R Bhad, Senior Resident1, A Mahapatra, Senior Resident1, R Verma, Assistant Prof.1, AK Mishra, Assistant Prof.1

1Department of Psychiatry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India

Corresponding Author:

Journal MTM 5:2:33–37, 2016

doi: 10.7309/jmtm.5.2.5

Introduction: Mobile apps are used as an aid in the mental health services in many high income countries. The present study was conducted to assess frequency of mobile phone use amongst patients with mental illness.

Methods: Patients attending psychiatric outpatient department of a public funded tertiary care hospital in India were assessed for use of mobile phone and its possible utility in mental health service delivery using a semi structured questionnaire.

Results: The study had 350 subjects, out of whom 307 (87.7%) reported using mobile phone on a regular basis. Mobile phone was used for phone calls, sending and receiving short text messages (SMS) recreation, and accessing social networking sites. Most of the users agreed that the mobile phone could be used as an aid in mental health service delivery, and expressed willingness to receive educational messages.

Conclusion: Patients with mental illness attending psychiatric outpatient services in India use mobile phones and are willing to use as a treatment aid.

The Future of Automated Mobile Eye Diagnosis

Posted on Jul 28, 2016 in Perspective Pieces | 0 comments

Cassie A. Ludwig, BS1, Mia X. Shan, BS, BAH1, Nam Phuong H. Nguyen1, Daniel Y. Choi, MD1, Victoria Ku, BS1, Carson K. Lam, MD1

1Byers Eye Institute, Stanford University School of Medicine 2405 Watson Drive, Palo Alto, CA, USA 94305

Corresponding Author:

Journal MTM 5:2:44–50, 2016

doi: 10.7309/jmtm.5.2.7

The current model of ophthalmic care requires the ophthalmologist’s involvement in data collection, diagnosis, treatment planning, and treatment execution. We hypothesize that ophthalmic data collection and diagnosis will be automated through mobile devices while the education, treatment planning, and fine dexterity tasks will continue to be performed at clinic visits and in the operating room by humans. Comprehensive automated mobile eye diagnosis includes the following steps: mobile diagnostic tests, image collection, image recognition and interpretation, integrative diagnostics, and user-friendly, mobile platforms. Completely automated mobile eye diagnosis will require improvements in each of these components, particularly image recognition and interpretation and integrative diagnostics. Once polished and integrated into greater medical practice, automated mobile eye diagnosis has the potential to increase access to ophthalmic care with reduced costs, increased efficiency, and increased accuracy of diagnosis.