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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
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: mlzuniga@mail.sdsu.edu
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
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: julie.wang@ucsf.edu
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.
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An integrated mHealth model for type 2 diabetes patients using mobile tablet devices
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: sora.park@canberra.edu.au
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.
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