Development of a Mobile App for Self-Care Against COVID-19 Using the Analysis, Design, Development, Implementation, and Evaluation (ADDIE) Model: Methodological Study

A Randomized Clinical Trial of Technology-Enhanced Family-Focused Therapy for Youth in the Early Stages of Mood Disorders

There are more than 318,000 mobile health apps available worldwide and more than 200 new apps become available each day. Although most are general wellness apps, the number of those related to patient care and management of health conditions continues to increase and has reached 40 percent of all health apps on the market. In fact, there is at least one high-quality app (i.e., apps with such attributes as good patient ratings, frequent updates, and promising clinical evidence) available to support patients’ needs at each stage of the care continuum, from prevention to treatment. More than 570 studies on mobile apps have been published, providing a robust amount of clinical evidence on their quality and effectiveness.1 One survey identified that 75 percent of U.S. health consumers believe technology, including apps, is important for managing their health. Mobile health apps are being embraced by patients for a multitude of uses, including virtual care and tracking, recording, and sharing health data, such as blood pressure and heart rate.2 Top uses for virtual care have included after-hours and follow-up appointments and concern-specific discussions. The use of virtual care continues to increase; 25 percent of surveyed consumers indicated they used these services in 2018, which is up from 21 percent in 2017. The majority of 2018 respondents who used these services (74 percent) said they were satisfied with the virtual care they received; in fact, approximately 50 percent of all respondents reported they would prefer a faster virtual care appointment than a delayed in-person visit.2 Moreover, 79 percent of U.S. consumers reported in another survey that they are more likely to choose a health care provider who has methods in place to connect virtually instead of one who does not.3 Ninety percent of patients surveyed indicated they are willing to share their health data obtained from mobile apps and wearable devices with their health care team.2 For health care professionals, mobile apps are beneficial for a range of uses, including to access medical references for point-of-care decisions; assist with hospital information systems, such as the electronic health record; communicate with other clinicians; perform training; and remotely monitor patients. In one survey, approximately 30 to 50 percent of U.S. clinicians reported using apps to actively engage in patient care, including to collect patient information at the bedside and monitor medical device information.3 Approximately 66 percent of the 100 biggest U.S. hospitals provide mobile apps for patients; 40 percent of these developed the apps in house.4 Health apps have been proven to reduce use of acute care services for diabetes, asthma, and cardiac and pulmonary rehabilitation; the use of apps in just these categories has the potential to save $7 billion in health care costs annually in the United States.1 Mobile apps can augment care for both patients and health care providers at all stages of care. Surveys of U.S. health care consumers and professionals point to an increasing adoption of this technology, highlighting the importance of identifying ways to incorporate these tools into patients’ health maintenance and care. This month’s lead feature discusses the use of mobile apps to aid patients in their postoperative recovery, including for medication compliance, pain management, and follow-up care.

FDA’s Streamlined Health App Approval: Better for Patients or Companies?

The increased use of the internet is due to the rapid evolution of personal digital services such as laptops, palmtops, tablets, and smartphones. Most companies and industries are currently investing more in the use of mobile shopping apps to increase their global market share and orders from mobile applications. The increased use of mobile app and social media platforms play critical role in the online shopping experience. The research paper employed both qualitative and quantitative research methods investigate how online shopping via mobile app affects online shopping experience. The one-on-one interview was used as a quantitative research method to collect data for the study. A descriptive statistic method was used to analyze the data obtained from the respondents. The results obtained from the two research methods show that the majority of the participants from this study had a good experience in terms of search convenience when shopping online via mobile app (mean: 5.16) than through website (mean: 4.74). 50% of the respondents had the quality experience when shopping via mobile app in terms of access convenience (mean: 4.12) than shopping via website mode (mean: 3.44). 47.3% of the sample size representing the female respondent in the study had a good experience when shopping using the mobile app mode in terms of ease of use compared to the website shopping mode. 60% of the end-users of the online mobile shopping had a bad experience in terms of security concerns associated with online shopping. The main objective of the study is to investigate the contribution of mobile apps and social media on the online shopping experience by online consumers. Besides, the paper conducts a rigorous analysis to analyze the effects of enlarging online business on the mobile shopping experience.

BackgroundEncouraging middle-aged adults to maintain their physical and cognitive health may have a significant impact on reducing the prevalence of dementia in the future. Mobile phone apps and interactive websites may be one effective way to target this age group. However, to date there has been little research investigating the user experience of dementia risk reduction tools delivered in this way.ObjectiveThe aim of this study was to explore participant engagement and evaluations of three different targeted smartphone and Web-based dementia risk reduction tools following a four-week intervention.MethodsParticipants completed a Web-based screening questionnaire to collect eligibility information. Eligible participants were asked to complete a Web-based baseline questionnaire and were then randomly assigned to use one of the three dementia risk reduction tools for a period of four weeks: (1) a mobile phone application; (2) an information-based website; and (3) an interactive website. User evaluations were obtained via a Web-based follow-up questionnaire after completion of the intervention.ResultsOf 415 eligible participants, 370 (89.16%) completed the baseline questionnaire and were assigned to an intervention group; 200 (54.05%) completed the post-intervention questionnaire. The average age of participants was 52 years, and 149 (75%) were female. Findings indicated that participants from all three intervention groups reported a generally positive impression of the tools across a range of domains. Participants using the information-based website reported higher ratings of their overall impression of the tool, F2,191=4.12, P=.02; how interesting the information was, F2,189=3.53, P=.03; how helpful the information was, F2,192=4.15, P=.02; and how much they learned, F2,188=3.86, P=.02. Group differences were significant between the mobile phone app and information-based website users, but not between the interactive website users and the other two groups. Additionally, participants using the information-based website reported significantly higher scores on their ratings of the ease of navigation, F2,190=4.20, P=.02, than those using the mobile phone app and the interactive website. There were no significant differences between groups on ratings of ease of understanding the information, F2,188=0.27, P=.76. Most participants from each of the three intervention groups indicated that they intended to keep using the dementia risk reduction eHealth tool.ConclusionsOverall, results indicated that while participants across all three intervention groups reported a generally positive experience with the targeted dementia risk reduction tools, participants using the information-based website provided a more favorable evaluation across a range of areas than participants using the mobile phone app. Further research is required to investigate whether targeted dementia risk reduction tools, in the form of interactive websites and mobile apps, can be improved to provide benefits above those gained by providing static information alone.

BackgroundThe prevalence of chronic disease is increasing rapidly. Health promotion models have shifted toward patient-centered care and self-efficacy. Devices and mobile app in the Internet of Things (IoT) have become critical self-management tools for collecting and analyzing personal data to improve individual health outcomes. However, the precise effects of Web-based interventions on self-efficacy and the related motivation factors behind individuals’ behavioral changes have not been determined.ObjectiveThe objective of this study was to gain insight into patients' self-efficacy with newly diagnosed diabetes (type 2 diabetes mellitus) and analyze the association of patient-centered health promotion behavior and to examine the implications of the results for IoT and mobile health mobile app features.MethodsThe study used data from the electronic health database (n=3128). An experimental design (n=121) and randomized controlled trials were employed to determine patient preferences in the health promotion program (n=62) and mobile self-management education (n=28). The transtheoretical model was used as a framework for observing self-management behavior for the improvement of individual health, and the theory of planned behavior was used to evaluate personal goals, execution, outcome, and personal preferences. A mobile app was used to determine individualized health promotion interventions and to apply these interventions to improve patients’ self-management and self-efficacy.ResultsMobile questionnaires were administered for pre- and postintervention assessment through mobile app. A dynamic questionnaire allocation method was used to follow up and monitor patient behavioral changes in the subsequent 6 to 18 months. Participants at a high risk of problems related to blood pressure (systolic blood pressure ≥120 mm Hg) and body mass index (≥23 kg/m2) indicated high motivation to change and to achieve high scores in the self-care knowledge assessment (n=49, 95% CI −0.26% to −0.24%, P=.052). The associated clinical outcomes in the case group with the mobile-based intervention were slightly better than in the control group (glycated hemoglobin mean −1.25%, 95% CI 6.36 to 7.47, P=.002). In addition, 86% (42/49) of the participants improved their health knowledge through the mobile-based app and information and communications technology. The behavior-change compliance rate was higher among the women than among the men. In addition, the personal characteristics of steadiness and dominance corresponded with a higher compliance rate in the dietary and wellness intervention (83%, 81/98). Most participants (71%, 70/98) also increased their attention to healthy eating, being active, and monitoring their condition (30% 21/70, 21% 15/70, and 20% 14/70, respectively).ConclusionsThe overall compliance rate was discovered to be higher after the mobile app–based health intervention. Various intervention strategies based on patient characteristics, health care–related word-of-mouth communication, and social media may be used to increase self-efficacy and improve clinical outcomes. Additional research should be conducted to determine the most influential factors and the most effective adherence management techniques.

Effectiveness of technology-based interventions to improve physical activity (PA) in people with COPD is controversial. Mixed results may be due to participants' characteristics influencing their use of and engagement with mobile health apps. This study compared demographic, clinical, physical and PA characteristics of patients with COPD using and not using mobile apps in daily life. Patients with COPD who used smartphones were asked about their sociodemographic and clinic characteristics, PA habits and use of mobile apps (general and PA-related). Participants performed a six-minute walk test (6MWT), gait speed test and wore an accelerometer for 7 days. Data were compared between participants using (App Users) and not using (Non-App Users) mobile apps. A sub-analysis was conducted comparing characteristics of PA–App Users and Non-Users. 59 participants were enrolled (73% Male; 66.3 ± 8.3 yrs; FEV1 48.7 ± 18.4% predicted): 59% were App Users and 25% were PA-App Users. Significant differences between App Users and Non-App Users were found for age (64.2 ± 8.9 vs. 69.2 ± 6.3yrs), 6MWT (462.9 ± 91.7 vs. 414.9 ± 82.3 m), Gait Speed (Median 1.5 [Q1–Q3: 1.4–1.8] vs. 2.0 [1.0–1.5]m/s), Time in Vigorous PA (0.6 [0.2–2.8] vs. 0.14 [0.1–0.7]min) and Self-Reported PA (4.0 [1.0–4.0] vs. 1.0 [0.0–4.0] Points). Differences between PA–App Users and Non-Users were found in time in sedentary behavior (764.1 [641.8–819.8] vs. 672.2 [581.2–749.4] min) and self-reported PA (4.0 [2.0–6.0] vs. 2.0 [0.0–4.0] points). People with COPD using mobile apps were younger and had higher physical capacity than their peers not using mobile apps. PA-App Users spent more time in sedentary behaviors than Non-Users although self-reporting more time in PA.

The primary objective of this paper is to examine how attitude to use may influence the use of mobile applications which in turn influence mobile users’ happiness in the context of the UAE government service sector. The paper tries to use an extension of the Technology Acceptance Model (TAM) to investigate the effect of different variables on mobile users’ attitudes towards the utilization of government mobile applications (GMAs). The significance of this thesis is based on the fact that it attempts to fill the gap regarding factors that affect the adoption and user happiness with the government mobile apps especially in the UAE where the utilization of the mobile apps is strategic for the delivery of efficient public services. By employing a quantitative approach, this paper obtained statistical data from a sample of 477 participants, which include UAE citizens and residents using one of GMAs provided by the Ministry of Interior (MOI). This paper is used mainly seven variables that predict degree of users’ happiness, including perceived trustworthiness, perceived effort expectancy, perceived app quality, perceived ease of use, perceived skills readiness, perceived security, and perceived usefulness. The findings highlight that higher perceptions towards mobile apps are significant predictors of user attitude and usage patterns. Additionally, the paper identifies that higher levels of each perceptions contribute to greater user of mobile apps use and happiness. Evidences from this paper may enrich the understanding of how governments can improve the adoption of modern technologies such as mobile apps and drive happiness among users.

BackgroundUsing digital health technologies to aid individuals in managing chronic diseases offers a promising solution to overcome health service barriers such as access and affordability. However, their effectiveness depends on adoption and sustained use, influenced by user preferences.ObjectivesThis study quantifies the preferences of individuals with chronic heart disease (CHD) for features of a mobile health app to self-navigate their disease condition.MethodsWe conducted an unlabeled web-based choice survey among adults older than 18 years with CHD living in Australia, recruited via a web-based survey platform. Four app attributes—ease of navigation, monitoring of blood pressure and heart rhythm, health education, and symptom diary maintenance—were systematically chosen through a multistage process. This process involved a literature review, stakeholder interviews, and expert panel discussions. Participants chose a preferred mobile app out of 3 alternatives: app A, app B, or neither. A D-optimal design was developed using Ngene software, informed by Bayesian priors derived from pilot survey data. Latent class model analysis was conducted using Nlogit software (Econometric Software, Inc). We also estimated attribute importance and anticipated adoption rates for 3 app versions.ResultsOur sample included 302 participants with a mean age of 50.5 (SD 18.2) years. Latent class model identified 2 classes. Older respondents with education beyond high school, prior experience with mobile health apps, and a positive perception of app usefulness were more likely to be in class 1 (257/303, 85%) than in class 2 (45/303, 15%). Class 1 membership preferred adopting a mobile app (app A: β coefficient 0.74, 95% uncertainty interval (UI) 0.41-1.06; app B: β coefficient 0.53, 95% UI 0.22-0.85). Participants favored apps providing postmonitoring recommendations (β coefficient 1.45, 95% UI 1.26-1.64), tailored health education (β coefficient 0.50, 95% UI 0.36-0.64), and unrestricted symptom diary entry (β coefficient 0.58, 95% UI 0.41-0.76). Class 2 showed no preference for app adoption (app A: β coefficient −1.18, 95% UI −2.36 to 0.006; app B: β coefficient −0.78, 95% UI −1.99 to 0.42) or any specific attribute levels. Vital sign monitoring was the most influential attribute among the 4. Scenario analysis revealed an 84% probability of app adoption with basic features, rising to 92% when app features aligned with respondents’ preferences.ConclusionsThe study’s findings suggest that designing preference-informed mobile health apps could significantly enhance adoption rates and engagement among individuals with CHD, potentially leading to improved clinical outcomes. Adoption rates were notably higher when app attributes included easy navigation, vital sign monitoring, feedback provision, personalized health education, and flexible data entry for symptom diary maintenance. Future research to explore factors influencing app adoption among different groups of patients is warranted.

With the rapid development of the mobile Internet, mobile reading has transcended the limitation of time and space, becoming an indispensable part of people’s living and learning. As the direct service object of mobile reading APP, users’ subjective use experience is decisive in the success or failure. It is of great significance to identify the key influencing factors of user experience of mobile reading APP. It is conducive not only to improving users reading experience and increasing users stickiness but also to improving mobile reading service quality, which is essential to promote the healthy and sustainable development of mobile reading APP. From the perspective of user experience, content analysis and questionnaire survey are used to construct the index system of influencing factors of mobile reading APP user experience, which includes 6 dimensions of reliability, usefulness, thoughtfulness, interactivity, security, and compatibility, and 21 influencing factors. Based on the decision-making trial and evaluation laboratory (DEMATEL) method, introducing the triangular fuzzy number, the fuzzy decision-making trial and evaluation laboratory (fuzzy-DEMATEL) model is established, extending the single value of the comparison matrix to a fuzzy interval and then giving the decision makers a proper judgment space. The key influencing factors of mobile reading APP user experience are identified by algorithm design. Ultimately, the 10 key influencing factors of mobile reading APP user experience are identified, which are information quality, content richness, value fit, copyright protection, timeliness, personalized service, reading function richness, interpersonal interaction, system performance, and privacy protection, and suggestions for improving the user experience of mobile reading APP are put forward to provide reference for mobile reading APP developers. The research results not only enrich and perfect the theoretical and practical research in the mobile reading field to a certain extent, providing a new research perspective for the field of mobile reading, but also effectively solve the defects of the traditional DEMATEL method that expert judgment is subjectively biased and difficult to express with an exact number directly. The research expands the application scope of DEMATEL.

BackgroundThe global aging population and the high incidence of falls among this population highlight the need for effective preventive strategies. Home-based exercise programs, such as the Otago protocol, have demonstrated efficacy in reducing fall risk but often face barriers related to user adherence. Mobile health (mHealth) apps offer promising tools to support health promotion and enhance autonomy in older adults.ObjectiveThis study aims to develop and validate a prototype mobile app, Mais Equilíbrio (More Balance), designed to guide older adults in performing home-based physical exercises adapted from the Otago protocol.MethodsThis methodological study was conducted in two phases: (1) content validation by 22 experts in physical education and physiotherapy using the Suitability Assessment of Materials (SAM) scale, and (2) usability testing with 24 older adults (aged 60 to 80 y), using the System Usability Scale (SUS). An overall score above 70% on the SAM and above 85 on the SUS were considered indicators of high quality and excellent usability, respectively.ResultsThe Mais Equilíbrio (More Balance) app was developed based on the Otago protocol and tailored for independent home use. A Content Validity Index above 0.95 was observed for all items. An overall average score of 81.20 (SD 15.78) on the SAM scale was found, classifying the material as “superior.” Usability tests with older adults showed an average score of 95.98 (SD 5.58) on the SUS, indicating excellent usability. The highest scores were observed in “ease of use” and “user confidence.”ConclusionsThe Mais Equilíbrio (More Balance) app, distinct for digitally adapting the Otago protocol to the Brazilian context and for its dual validation process with experts and older adults, has proven to be a valid and highly usable tool for guiding home-based physical exercise in older adults, with potential to promote fall prevention and autonomy.

Mobile app usability has been attracting the attention of academics and practitioners for sometime because well-designed mobile apps can build a close link between businesses and users in addition to enhancing user experiences. To better understand mobile app usability, this study develops a unified hierarchical approach that characterizes mobile app usability from the high level of “usability principles” to the intermediary level of “usability attributes” to the detailed level of “usability features” to assess the usability of current mobile apps from different categories. Using an online survey, we identified a set of usability design features that are common to all categories of apps. Furthermore, the study identifies a set of important and less important usability features within specific mobile app categories. In addition to the practical implications consisting of insights for mobile app design, the study found important relationships among usability principles, attributes, and features.

BackgroundThe advances achieved in technology, medicine, and communications in the past decades have created an excellent scenario for the improvement and expansion of eHeath and mHealth in particular. Mobile phones, smartphones, and tablets are exceptional means for the application of mobile health, especially for those diseases and health conditions that are the deadliest worldwide.ObjectiveThe main aim of this paper was to compare the amount of research and the number of mobile apps dedicated to the diseases and conditions that are the leading causes of death according to the World Health Organization grouped by different income regions. These diseases and conditions were ischemic heart disease; stroke and other cerebrovascular diseases; lower respiratory infections; chronic obstructive pulmonary disease; diarrheal diseases; HIV/AIDS; trachea, bronchus, and lung cancers; malaria; and Alzheimer disease and other dementias.MethodsTwo reviews were conducted. In the first, the systems IEEE Xplore, Scopus, Web of Knowledge, and PubMed were used to perform a literature review of applications related to the mentioned diseases. The second was developed in the currently most important mobile phone apps stores: Google play, iTunes, BlackBerry World, and Windows Phone Apps+Games.ResultsSearch queries up to June 2013 located 371 papers and 557 apps related to the leading causes of death, and the following findings were obtained. Alzheimer disease and other dementias are included in the diseases with more apps, although it is not among the top 10 causes of death worldwide, whereas lower respiratory infections, the third leading cause of death, is one of the less researched and with fewer apps. Two diseases that are the first and second of low-income countries (lower respiratory infections and diarrheal diseases) have very little research and few commercial applications. HIV/AIDS, in the top 6 of low-income and middle-income zones, is one of the diseases with more research and applications, although it is not in the top 10 in high-income countries. Trachea, bronchus, and lung cancers are the third cause of death in high-income countries but are one of the least researched diseases with regard to apps.ConclusionsConcerning mobile apps, there is more work done in the commercial field than in the research field, although the distribution among the diseases is similar in both fields. In general, apps for common diseases of low- and middle-income countries are not as abundant as those for typical diseases of developed countries. Nevertheless, there are some exceptions such as HIV/AIDS, due to its important social conscience; and trachea, bronchus and lung cancers, which was totally unexpected.

Interventions to promote health and well-being based on the construction of psychological resources can positively impact the daily life of users and foster human flourishing. Nowadays, mobile health represents a safe way to support health research and implement evidence-based psychological interventions. The present study aims to evaluate the effectiveness of a mobile app-based intervention program (OneUS) designed to cultivate positive emotions and positive thinking to improve overall well-being. The study is designed as a randomized controlled trial. Two hundred participants will be randomly assigned to either a mobile health intervention condition (OneUS App) or an active control condition. The intervention consists of a program to cultivate positive emotions and positive thoughts. The active control intervention will comprise a set of mental imagery exercises and daily routine recording. The primary outcome comprises optimal well-being assessed using the multidimensional PERMA-Profiler scale. The sample will include adult people from the general population, who will be assessed at 8 time points: baseline (t1), intervention (t2, t3, t4, t5, t6) post-intervention (t7) and 3-month follow-up (t8). Mobile apps seem to be promising tools to promote health and well-being. This study will evaluate the effectiveness of a mobile app (OneUS) aiming to cultivate positive emotions and positive thinking to improve well-being. The main strength of this study is the development of an evidence-based mobile health app, based on intentional mental training, to promote well-being. The limitations of this study relate to potential participant drop-out and the non-generalizability of the results to clinical populations. https://ensaiosclinicos.gov.br/rg/RBR-43hpwqk, Identifier RBR-43hpwqk.

The purpose of this research was to reveal whether the Guidance and Counseling module designed for increasing the students’ self-esteem had been proper in terms of content and appearance, and to describe the usability level of the Guidance and Counseling module to increase the students’ self-esteem. This research applied ADDIE (Analysis, Design, Development, Implementation, and Evaluation) model. The subjects of the research consisted of 6 experts to see the properness of the module and 3 Guidance and Counseling teachers to see the usability level of the module. This research was conducted by trying out the product and through Focus Group Discussion (FGD). The data of the research were analyzed by using descriptive statistic analysis and inferensial statistic. Based on these results, in general, the prototype of Guidance and Counseling module designed for increasing the students’ self-esteem had been proper and could be used by the Guidance and Counseling teachers to increase the students’ self-esteem.