No abstract

Mobile health (mHealth) apps have the potential to enhance pain management through the use of daily diaries, medication and appointment reminders, education, and facilitating communication between patients and providers. Although many pain management apps exist, the extent to which these apps use evidence-based behavior change techniques (BCTs) remains largely unknown, making it nearly impossible for providers to recommend apps with evidence-based strategies. This study systematically evaluated commercially available pain management apps for evidence-based BCTs and app quality. Pain management apps were identified using the search terms “pain” and “pain management” in the App and Google Play stores. Reviewed apps were specific to pain management, in English, for patients, and free. A total of 28 apps were coded using the taxonomy of BCTs. App quality was assessed using the Mobile App Rating Scale. Apps included 2 to 15 BCTs (M = 7.36) and 1 to 8 (M = 4.21) pain management–specific BCTs. Prompt intention formation, instruction, behavioral-health link, consequences, feedback, and self-monitoring were the most common BCTs used in the reviewed apps. App quality from the Mobile App Rating Scale ranged from 2.27 to 4.54 (M = 3.65) out of a possible 5, with higher scores indicating better quality. PainScale followed by Migraine Buddy demonstrated the highest number of overall and pain management BCTs as well as good quality scores. Although existing apps should be assessed through randomized controlled trials and future apps should include capabilities for electronic medical record integration, current pain management apps often use evidence-based pain management BCTs.

Adults with diabetes frequently experience diabetes related distress, which is associated with negative health outcomes. Family members are commonly involved in patients’ diabetes self-management. However, family involvement can have helpful and/or harmful effects on patients’ diabetes outcomes. Use of interpersonal strategies to regulate negative emotions may play a role in patients’ interactions with family members and experience of diabetes distress. This study examined the influences of interpersonal emotion regulation and family and friend involvement on diabetes distress among 373 adults with type 2 diabetes. Two separate three-step sequential linear regression models were used to test the main and interactive effects of harmful and helpful family involvement and interpersonal emotion regulation on diabetes distress. Greater use of interpersonal strategies to regulate negative emotions ( p = .006) and greater harmful family involvement ( p < .001) were significantly associated with greater diabetes distress. Interpersonal emotion regulation moderated the relationship of helpful ( p = .007), but not harmful ( p = .171) family involvement on diabetes distress. Specifically, greater helpful family involvement was associated with lower diabetes distress among adults with low ( p = .017) but not high ( p = .419) use of interpersonal strategies to regulate negative emotions. Helpful family involvement appears to be associated with lower diabetes distress, but only among patients with low levels of interpersonal emotion regulation.

Background: Adults with diabetes often receive self-management support from family and friends (care partners) living in and outside of their home. Helpful involvement from care partners (CPs) has positive impacts on diabetes self-management. Less is known regarding the relationship between the number of CPs and the level of helpful and harmful involvement. We examined the relationship between the number of in and out-of-home CPs and helpful and harmful involvement in patients’ diabetes self-management. Methods: Adults with type 2 diabetes (N=369) were recruited from a web-based panel. Participants completed the Family and Friend Involvement in Adults’ Diabetes (FIAD) scale and reported the number of in and out-of-home CPs who provide help with their diabetes self-management. A two-step hierarchical linear regression was used to examine the linear and quadratic trends between number of in and out-of-home CPs and helpful and harmful involvement in diabetes self-care, controlling for age, sex, ethnicity, and socioeconomic status. Results: There was a positive linear relationship between the number of in and out-of-home CPs, and helpful and harmful involvement (p’s; range &lt; .001 to .003). The addition of quadratic terms accounted for a significant increase in explained variance in helpful and harmful involvement (p’s &lt; .001). There was a positive trend between the number of in and out-of-home CPs and helpful and harmful involvement among adults with up to approximately 5 CPs. In contrast, there was a negative trend between these variables among individuals with 5 or more CPs. Conclusions: Patients with a relatively small or large number of CPs, receive less helpful and harmful support. Large CP networks are not necessarily indicative of high levels of helpful involvement in patients’ diabetes self-care. CP interventions should attempt to enhance helpful involvement while minimizing harmful involvement in these populations. Disclosure B. Lewis: None. S. R. Kollin: None. A. A. Lee: None.

SummaryBackgroundYouth with attention‐deficit hyperactivity disorder (ADHD) are more vulnerable to developing obesity. Stimulant medication use, an evidence‐based treatment for ADHD, is associated with lower body mass index (BMI) and higher blood pressure among non‐overweight youth.ObjectivesThe purpose of this study was to examine the longitudinal influence of ADHD and stimulant medication use on BMI and blood pressure among a sample of 456 youth with overweight and obesity treated in a paediatric weight management clinic.MethodsMixed linear modelling examined the main and interactive effects of time by ADHD status and stimulant medication use on BMI and blood pressure.ResultsYouth without ADHD experienced a significantly faster decrease in BMI compared to youth with ADHD (p < 0.001). Youth with ADHD who were taking stimulant medication had a significantly faster decrease in BMI compared to youth with ADHD who were not taking stimulant medication (p = 0.009). There was no significant effect of ADHD status or stimulant medication use on diastolic or systolic blood pressure trajectories over time (ps >0.05).ConclusionsResults from this study suggest that youth with ADHD who are not taking stimulant medication may not benefit from clinical weight management to the same extent as either youth without ADHD or youth with ADHD who are taking a stimulant medication.