Objective: The objective of the study was to implement a user-centred approach in the design and development of smartphone game-based applications (SGA) prototypes for PA promotion in adolescents, specifically from low SES families.

Aims: (1) Describe the development of smartphone game-based applications to promote physical activity in adolescents from primarily low socioeconomic status households. (2) Determine acceptability of initial prototypes.

Methods: This study implemented a user-centred approach including adolescent focus groups (n =3; 14 adolescents), parent interviews (n=7), and idea generation sessions (n=5; 80 participants) to develop and design smartphone applications as a persuasive technology for adolescents.

Results: Qualitative data demonstrated that adolescents identified smartphone features that would have the ability to have frequent opportunities for social networking and competition. The majority of parents had favourable perceptions of smartphone games for physical activity promotion. Furthermore, idea generating centred around sports and recreational games. A final set of games were developed into hand drawn and computer generated prototypes.

Conclusions: The study provides a framework for how to incorporate a user-centred approach in the design and prototype development of smartphone game-based applications, and indicates the feasibility of continued smartphone game-based applications development and effectiveness testing for promoting physical activity among low socioeconomic adolescents.

Background: HIV prevalence remains disproportionately high among youth, especially among young men who have sex with men, young people with substance use disorders, and recently incarcerated youth. However, youth may not report behavioral risks because they fear stigma or legal consequences. While routine HIV screening programs have increased testing, current programs are not designed to identify, or provide prevention services to, high-risk patients who test HIV negative.

Aims: To examine the feasibility and preliminary efficacy of: a tablet-based screening designed to facilitate HIV risk reporting and testing among a sample of young urban emergency department (ED) patients; and a text message-based follow up protocol for patients who test HIV-negative and report increased behavioral risk.

Methods: 100 ED patients aged 18–24, who declined HIV tests offered at triage, completed a tablet-based intervention that included a risk screening, an educational video, and offered participants HIV tests. If patients accepted testing and reported increased risk, the tablets offered follow-up text messages.

Results: 30 participants accepted HIV tests following the intervention and 21 participants, identified by custom software as high-risk, agreed to receive text messages. Two thirds (66.7%) of text recipients responded to questions at week 6, more than half (57.1%) responded at week 8, one (4.76%) re-tested after week 12.

Conclusion: Results indicate our intervention provides a feasible way to facilitate risk reporting, increase HIV testing, and maintain ongoing contact with hard-to-reach youth via tablet computers and text messages.

Objectives: To determine the agreement and correlation of visual acuity between Rapid Eye Screening Test (REST) app and Early Treatment Diabetic Retinopathy Study (ETDRS) tumbling ‘E’ chart.

Methods: A visual acuity tool was designed for Android and iOS users based on ETDRS. A pilot study was conducted involving 101 subjects. Visual acuity of each subject was tested using ETDRS chart and crossover to REST at 3 meters or vice versa.

Results: Mean visual acuity using ETDRS was 0.086 ± 0.194 for right eye (RE) and 0.085 ± 0.196 for left eye (LE) while REST measurement was 0.091 ± 0.182 for RE and 0.098 ± 0.203 for LE. There was significant and strong direct correlation between visual acuity using ETDRS and REST in both eyes (RE: r = 0.829; p < 0.001, LE: r = 0.871; p < 0.001). The 95% limits of agreement between the two charts was ±0.11 LogMAR for right eye and ±0.10 LogMAR for left eye. Time taken for REST was significantly shorter than ETDRS (p < 0.001).

Conclusion: REST is accurate and time-saving, thus potentially ideal for mass screening in remote area.

Background: Persons who inject drugs (PWID) are at high risk for hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infection, particularly in Tijuana, Baja California, Mexico, where HCV prevalence among PWID is above 95%. PWID also demonstrate low access and use of health services. mHealth intervention tools may prove effective for reducing disease risk and increasing access to health services for PWID. However, knowledge of cell phone access within this population is needed before designing such interventions.

Methods: We aimed to determine the prevalence and correlates of cell phone access among PWID enrolled in the ‘El Cuete’ cohort study in Tijuana. Participants were asked for detailed contact information at baseline—including a cell phone number if available—to facilitate retention. Interviews obtained socio-demographic data, health information, and lifetime/recent drug and sexual risk behaviors. Logistic regression was used to assess factors independently associated with providing a cell phone number.

Results: Of 735 participants enrolled, 16% of participants had access to a cell phone at baseline. Mean age was 37 years old, ranging from 18–63. Sixty two percent of participants were male, 96% were Hispanic, and 27% reported recent homelessness. Higher education and a monthly income≥2500 pesos were associated with higher odds of cell phone access. Inversely, homelessness, daily injection drug use, and older age were associated with lower odds of cell phone access.

Conclusions: Cell phone access among PWID in Tijuana is low and should be considered in the design of mHealth interventions targeting this population.

Background: Mobile phone text messaging has become increasingly popular and text-based systems for patients with chronic diseases like diabetes are being rapidly developed. A paucity of information exists about preferences for and acceptance of health-related text messages by patients for self-management support.

Aims: To evaluate the use of mobile phones, acceptance of text messaging, and perspectives on receiving tailored text messages in adults with diabetes.

Methods: A total of 48 subjects were recruited into a randomized controlled study to improve medication adherence; 21 individuals provided responses on technology acceptance and 12 semi-structured telephone interviews were conducted at follow-up. After 90 days of tailored text messages, intervention arm subjects provided feedback on acceptance of the technology, personal perspectives on the receipt of tailored materials, and preferences for mobile phone use as part of their diabetes self-management.

Results: On average, participants exchanged less than 10 messages per day and those texting more frequently tended to be younger and owned smartphones. Participants’ perception of the utility and ease of use of text messaging was positive, both of which were more positive among participants with greater perceived competence for managing their diabetes and lower perceived barriers to treatment. Subjects felt that receiving one message per day was appropriate and they benefitted from the content. In general, subjects indicated the messages were primarily useful as reminders rather than a source of new information.

Conclusions: Acceptance of tailored text messages was high in adults with diabetes and subjects felt they could benefit from receiving similar messages in the future.

Background: The SWAY Balance Mobile Application is an FDA-cleared balance testing system which uses the built-in tri-axial accelerometers of a mobile electronic device to objectively assess postural movement. The system was designed to provide a means of quantitative balance assessment in clinical and on-field environments. The purpose of this study was to determine the intrasession and intersession reliability, as well as the minimum difference to be considered real, of the SWAY Balance Mobile Application.

Methods: 24 individuals (15 male, 9 female; aged 25.96 (±5.78 years)) performed the SWAY Balance protocol twice per testing session over a period of three testing sessions. Each testing session was separated by a minimum of seven days. Interclass Correlation Coefficients were calculated as an indication of the test-retest reliability. The minimum difference to be considered real was calculated to determine the minimum score change necessary to indicate an actual change in balance performance.

Results: Mean SWAY Balance scores ranged from 86.90 (±14.37) to 89.90 (±11.19). Repeated measures ANOVA revealed no significant mean differences between SWAY balance scores of the experimental trials (F_(5,115) = 0.673; p = 0.65). Excellent reliability was found (ICC(3,1) = 0.76; SEM = 5.39) with a minimum difference to be considered real of approximately 15.

Conclusions: Results indicate that SWAY provides excellent overall reliability. However, it may be appropriate to have subjects perform a familiarization trial at the beginning of each testing session. Additionally, SWAY may demonstrate a ceiling effect when assessing balance improvements in those who already demonstrate good balance.