mHealth or eHealth? Efficacy, Use, and Appreciation of a Web-Based Computer-Tailored Physical Activity Intervention for Dutch Adults: A Randomized Controlled Trial

Quiñonez, S. Gomez; Walthouwer, Michel Jean Louis; Schulz, Daniela N; Vries, Hein de

doi:10.2196/jmir.6171

Cited by 53 publications

(32 citation statements)

References 55 publications

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“…Such reliable rating would enable examination of programs leveraging more than one delivery medium and comparison between the qualities of programs regardless of their delivery mediums. Recently, Gomez Quiñonez et al [35] demonstrated that a Web-based app targeting adult physical activity provided better or similar results compared to the same mHealth app. Subsequently, in a recent systematic review of digital parent training programs, only one mobile app was identified, which was used as an adjunct to treatment, whereas most computer programs were used as a standalone intervention [36].…”

Section: Introductionmentioning

confidence: 99%

Enlight: A Comprehensive Quality and Therapeutic Potential Evaluation Tool for Mobile and Web-Based eHealth Interventions

Baumel¹,

Faber²,

Mathur³

et al. 2017

J Med Internet Res

185

196

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BackgroundStudies of criteria-based assessment tools have demonstrated the feasibility of objectively evaluating eHealth interventions independent of empirical testing. However, current tools have not included some quality constructs associated with intervention outcome, such as persuasive design, behavior change, or therapeutic alliance. In addition, the generalizability of such tools has not been explicitly examined.ObjectiveThe aim is to introduce the development and further analysis of the Enlight suite of measures, developed to incorporate the aforementioned concepts and address generalizability aspects.MethodsAs a first step, a comprehensive systematic review was performed to identify relevant quality rating criteria in line with the PRISMA statement. These criteria were then categorized to create Enlight. The second step involved testing Enlight on 42 mobile apps and 42 Web-based programs (delivery mediums) targeting modifiable behaviors related to medical illness or mental health (clinical aims).ResultsA total of 476 criteria from 99 identified sources were used to build Enlight. The rating measures were divided into two sections: quality assessments and checklists. Quality assessments included usability, visual design, user engagement, content, therapeutic persuasiveness, therapeutic alliance, and general subjective evaluation. The checklists included credibility, privacy explanation, basic security, and evidence-based program ranking. The quality constructs exhibited excellent interrater reliability (intraclass correlations=.77-.98, median .91) and internal consistency (Cronbach alphas=.83-.90, median .88), with similar results when separated into delivery mediums or clinical aims. Conditional probability analysis revealed that 100% of the programs that received a score of fair or above (≥3.0) in therapeutic persuasiveness or therapeutic alliance received the same range of scores in user engagement and content—a pattern that did not appear in the opposite direction. Preliminary concurrent validity analysis pointed to positive correlations of combined quality scores with selected variables. The combined score that did not include therapeutic persuasiveness and therapeutic alliance descriptively underperformed the other combined scores.ConclusionsThis paper provides empirical evidence supporting the importance of persuasive design and therapeutic alliance within the context of a program’s evaluation. Reliability metrics and preliminary concurrent validity analysis indicate the potential of Enlight in examining eHealth programs regardless of delivery mediums and clinical aims.

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Section: Introductionmentioning

confidence: 99%

Enlight: A Comprehensive Quality and Therapeutic Potential Evaluation Tool for Mobile and Web-Based eHealth Interventions

Baumel¹,

Faber²,

Mathur³

et al. 2017

J Med Internet Res

185

196

View full text Add to dashboard Cite

show abstract

“…Electronic and telehealth tools are increasingly commonplace, can be provided at relatively low cost2 and incorporate personally relevant health information 3. For those vulnerable and underserved community members with chronic or long-term conditions, electronic applications may enhance the reach of health services and the provision of tailored need-based services 4 5.…”

Section: Introductionmentioning

confidence: 99%

Electronic, mobile and telehealth tools for vulnerable patients with chronic disease: a systematic review and realist synthesis

et al. 2018

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ObjectivesThe objective of this review was to assess the benefit of using electronic, mobile and telehealth tools for vulnerable patients with chronic disease and explore the mechanisms by which these impact patient self-efficacy and self-management.DesignWe searched MEDLINE, all evidence-based medicine, CINAHL, Embase and PsychINFO covering the period 2009 to 2018 for electronic, mobile or telehealth interventions. Quality was assessed according to rigour and relevance. Those studies providing a richer description (‘thick’) were synthesised using a realist matrix.Setting and participantsStudies of any design conducted in community-based primary care involving adults with one or more diagnosed chronic health condition and vulnerability due to demographic, geographic, economic and/or cultural characteristics.ResultsEighteen trials were identified targeting a range of chronic conditions and vulnerabilities. The data provided limited insight into the mechanisms underpinning these interventions, most of which sought to persuade vulnerable patients into believing they could self-manage their conditions through improved symptom monitoring, education and support and goal setting. Patients were relatively passive in the interaction, and the level of patient response attributed to their intrinsic level of motivation. Health literacy, which may be confounded with motivation, was only measured in one study, and eHealth literacy was not assessed.ConclusionsResearch incorporating these tools with vulnerable groups is not comprehensive. Apart from intrinsic motivation, health literacy may also influence the reaction of vulnerable groups to technology. Social persuasion was the main way interventions sought to achieve better self-management. Efforts to engage patients by healthcare providers were lower than expected. Use of social networks or other eHealth mechanisms to link patients and provide opportunities for vicarious experience could be further explored in relation to vulnerable groups. Future research could also assess health and eHealth literacy and differentiate the specific needs for vulnerable groups when implementing health technologies.

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“…Mobile health (mHealth) apps offer many advantages over eHealth systems, including (1) instantaneous and personalized feedback; (2) self-directing data collection; (3) user-friendly interfaces; (4) evaluator bias reductions; and (5) lower costs by reducing face-to-face procedures [ 25 ]. To date, several mHealth apps have been developed to promote healthy lifestyles in the general population [ 26 - 30 ], and for some pathologies, such as cardiac rehabilitation [ 31 ], weigh loss interventions for endometrial carcinoma [ 32 ], and exercise and nutrition counseling for breast cancer survivors [ 33 ]. However, no mHealth app has been developed specifically for breast cancer survivors that simultaneously records energy balance (intake and physical activity), and provides immediate energy balance feedback.…”

Section: Introductionmentioning

confidence: 99%

Monitoring Energy Balance in Breast Cancer Survivors Using a Mobile App: Reliability Study

Lozano‐Lozano¹,

Galiano‐Castillo²,

Martín-Martín³

et al. 2018

JMIR Mhealth Uhealth

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BackgroundThe majority of breast cancer survivors do not meet recommendations in terms of diet and physical activity. To address this problem, we developed a mobile health (mHealth) app for assessing and monitoring healthy lifestyles in breast cancer survivors, called the Energy Balance on Cancer (BENECA) mHealth system. The BENECA mHealth system is a novel and interactive mHealth app, which allows breast cancer survivors to engage themselves in their energy balance monitoring. BENECA was designed to facilitate adherence to healthy lifestyles in an easy and intuitive way.ObjectiveThe objective of the study was to assess the concurrent validity and test-retest reliability between the BENECA mHealth system and the gold standard assessment methods for diet and physical activity.MethodsA reliability study was conducted with 20 breast cancer survivors. In the study, tri-axial accelerometers (ActiGraphGT3X+) were used as gold standard for 8 consecutive days, in addition to 2, 24-hour dietary recalls, 4 dietary records, and sociodemographic questionnaires. Two-way random effect intraclass correlation coefficients, a linear regression-analysis, and a Passing-Bablok regression were calculated.ResultsThe reliability estimates were very high for all variables (alpha≥.90). The lowest reliability was found in fruit and vegetable intakes (alpha=.94). The reliability between the accelerometer and the dietary assessment instruments against the BENECA system was very high (intraclass correlation coefficient=.90). We found a mean match rate of 93.51% between instruments and a mean phantom rate of 3.35%. The Passing-Bablok regression analysis did not show considerable bias in fat percentage, portions of fruits and vegetables, or minutes of moderate to vigorous physical activity.ConclusionsThe BENECA mHealth app could be a new tool to measure energy balance in breast cancer survivors in a reliable and simple way. Our results support the use of this technology to not only to encourage changes in breast cancer survivors' lifestyles, but also to remotely monitor energy balance.Trial RegistrationClinicalTrials.gov NCT02817724; https://clinicaltrials.gov/ct2/show/NCT02817724 (Archived by WebCite at http://www.webcitation.org/6xVY1buCc)

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mHealth or eHealth? Efficacy, Use, and Appreciation of a Web-Based Computer-Tailored Physical Activity Intervention for Dutch Adults: A Randomized Controlled Trial

Cited by 53 publications

References 55 publications

Enlight: A Comprehensive Quality and Therapeutic Potential Evaluation Tool for Mobile and Web-Based eHealth Interventions

Enlight: A Comprehensive Quality and Therapeutic Potential Evaluation Tool for Mobile and Web-Based eHealth Interventions

Electronic, mobile and telehealth tools for vulnerable patients with chronic disease: a systematic review and realist synthesis

Monitoring Energy Balance in Breast Cancer Survivors Using a Mobile App: Reliability Study

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