BackgroundThe onset of type 2 diabetes mellitus can be prevented or delayed by lifestyle changes. Communication technologies such as a mobile phone can be used as a means of delivering these lifestyle changes.ObjectivesThe purposes of this analysis were to explore applicability of potential components of a mobile phone-based healthy lifestyle program and to understand motivators and barriers to continued engagement in a mobile phone healthy lifestyle program.MethodsWe conducted 6 focus groups (4 female and 2 male groups) in May and June 2010 with 35 focus group participants. The qualitative data were analyzed by 3 researchers using a qualitative description method in an ATLAS.ti software program. Inclusion criteria for enrollment in a focus group were as follows: (1) being aged from 30 to 69 years, (2) speaking and reading English, (3) having a sedentary lifestyle at work or during leisure time (screened by the Brief Physical Activity Survey questionnaire), and (4) having a body mass index (BMI) >25 kg/m2 (Asian >23 kg/m2) based on self-reported weight and height or 5) having a self-reported prediabetic condition.ResultsThe mean age was 51 (SD 10.6) years; 54% (n = 19) were white; 71% (n = 25) used a mobile phone at least once a week during the last month prior to the study enrollment; and mean BMI was 32.5 (SD 6.5) kg/m2. In the qualitative analyses, the following 4 major themes and their subthemes emerged: (1) real-time social support (real-time peer support from participants who are similarly engaged in a diet or physical activity program, and professional support from health care providers or a researcher), (2) tailoring of mobile phone programs (3) self-monitoring and motivation, and (4) potential barriers and sustainability of the program (fear of failing, age and mobile technologies, and loss of interest over time).ConclusionsParticipants from a wide range of age and racial groups expressed interest in a mobile phone-based lifestyle program. Such a program that incorporates the themes that we identified may be able to help motivate participants to increase their physical activity and to improve their diet.

Based on combined methods, this study investigated substance use and HIV risk behaviors among kathoey sex workers (KSWs) in Bangkok, Thailand. The study found that only half of the KSW participants reported having been tested for HIV, and that except for one participant, all others had not seen health care providers in the past 12 months. About one third of the participants reported having engaged in unprotected anal sex with customers in the past 6 months. Almost all participants reported alcohol use, as well as having had sex with customers under the influence of alcohol. The prevalence of marijuana and ecstasy use in the past 12 months was high (32% and 36%, respectively); as was for ketamine (20%) and non-injecting methamphetamine (yaba) use (10%). A multiple regression analysis showed that the participants who were post-operative status, had used illicit drugs, or had been abused by their father and brothers were less likely to use condoms for anal sex with customers. Three quarters of the participants sent money to their families and 35% of the participants expressed their willingness to engage in unsafe sex when customers offer extra money. The qualitative interviews revealed that many identified as girl or kathoey in early age and had been exposed to transphobia and violence from father and brothers. Some reported support for gender transition from their mothers. More than half of the participants currently had difficulties in living as kathoey, such as challenges in job market and relationship with family members. Family obligation for sending money and the Buddhist concept of karma were discussed in relation to risk behaviors among KSWs. The study provided implications for facilitating HIV testing and developing future HIV prevention intervention programs for KSWs in Thailand.

Repeating the BinaxNOW antigen test for SARS-CoV-2 by two groups of readers within 30 minutes resulted in high concordance (98.9%) in 2,110 encounters. BinaxNOW test sensitivity was 77.2% (258/334) compared to real-time reverse transcription-polymerase chain reaction. Same day antigen testing did not significantly improve test sensitivity while specificity remained high.

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Objectives-The purposes of this study were 1) to determine compliance with a pedometer and mobile phone-based physical activity diary, and 2) to assess concordance between self-reported daily steps recorded and transmitted by a mobile phone and pedometer-measured daily steps in sedentary women.Methods-In this 3-week pilot clinical study, 41 sedentary women who met all inclusion criteria were recruited from local communities. We asked the participants to wear a pedometer every day and to report their daily steps using a mobile phone diary each night before retiring. In the first week, women were asked to monitor their daily steps (baseline steps). In the second and third weeks, they were asked to increase their steps by 20% from the previous week. Although the pedometer can automatically store the most recent 41 days' performance, the participants were not informed of this function of the pedometer.Results-Overall compliance was 93.8% with pedometer use and 88.3% with the mobile phone physical activity diary. Bland Altman plots showed that the agreement between self-reported daily steps by mobile phone diary and pedometer-recorded daily steps from week 1 to week 3 was high.Conclusion-The combination of a pedometer and a mobile phone diary may enhance the quality of self-reported data in clinical studies.