Acceptability of Mobile Health Technology for Promoting Fluid Consumption in Patients With Nephrolithiasis

Abstract

Patients are interested in lifestyle behavior change to prevent stones but technology has not been widely adopted to improve adherence to fluid intake recommendations for stone prevention. This study identified a number of viable mHealth intervention components that should be considered when designing a stone-specific mHealth technology to support adherence to increased fluid consumption recommendations.

Just-in-time adaptive intervention to promote fluid consumption in patients with kidney stones.

“…Barriers to adherence were assessed at baseline and follow-up assessments using a checklist based on formative research (Streeper et al, 2018(Streeper et al, , 2019. This item read, "Which of the following have been barriers to meeting fluid-intake guidelines for preventing stones (i.e., drinking enough to produce 2.5 L/day of urine)?…”

“…For example, mobile apps commonly include self-tracking functions, but users can find this technique burdensome and not record intake as a result (Conroy et al, 2016). Patients have expressed interest in connected water bottles that can sense fluid intake from the bottle and transmit it to a companion smartphone app, but these devices are not sensitive to fluids consumed from other containers (e.g., coffee mugs, water fountains; Streeper et al, 2018). Additionally, they often can only record water intake and may not be acceptable in certain social situations.…”

“…Sending too many notifications or notifications that are perceived as unnecessary or unhelpful contributes to notification fatigue, which can reduce attention to alerts and long-term engagement (Cole- Lewis et al, 2019;Heckman, Mathew, & Carpenter, 2015;Wilken et al, 2017). Patients have indicated that lapse-contingent notifications would be valued as part of a fluid-intake intervention (Streeper et al, 2018(Streeper et al, , 2019. The decision rule for sip IT notifications specifies that if the monitoring system indicates that the patient consumed a prespecified amount of fluids since the last decision point, then the reminder notification should be canceled; otherwise (else), the reminder notification should be delivered.…”

“…Yet less than half of patients with stones adhere to this seemingly simple recommendation (Khambati, Matulewicz, Perry, & Nadler, 2017; van Drongelen, Kiemeney, Debruyne, & de la Rosette, 1998). Patients have reported interest in using digital tools to support adherence to this guideline (Streeper, Lehman, & Conroy, 2018; Streeper et al, 2019). This study presents the initial evaluation of a new digital tool called sip IT that combines consumer wearables, the science of behavior change, and informatics tools to support fluid intake in patients with a history of kidney stones.…”

The use of mobile applications in urology. A systematic review

“…Fifty-eight percent of smartphone users in the US have downloaded an mHealth application to support healthy behaviour. 2 In a study by Streeper et al, 3 few patients reported having ever installed an application to help prevent kidney disease or increase fluid consumption; however, most participants generally believed that mHealth technology would improve their fluid intake.…”