Jacob, Rachel

Gopalakrishnan T.R., Jacob R., Periyandavar I.

This study explores the interplay between fear or threat perception and adoption of health apps among individuals with diabetes. It draws on the concept of "fear" as an emotional response stemming from perceived threat, raising the question of whether threat perception drives the uptake of health apps.This study investigates the influence of diabetes threat perception on app adoption, akin to the role of fear appeal in behavior change communication. This study employed both a handout questionnaire and an online survey tool, Survey Monkey, for data collection. Using purposive sampling, data were collected from 222 individuals aged 35 years and above with diabetes in Chennai.The results indicate that threat perception can trigger health app usage among people with high diabetic conditions, supporting the broader literature on fear appeal. Additionally, the perceived threat of diabetes is elevated among app users. Notably, a significant positive correlation exists between perceived threat of diabetes, daily app usage, and consistent app use.This study underscores that the extent of perceived harm or vulnerability to threats influences individuals' behavioral changes. It introduces new avenues for encouraging health app usage among high-risk groups.

Visuals and words always create a narrative impact on the minds of the readers. Visual data or infographics enable readers to understand and comprehend complex information effortlessly. In an era of technological development, consumption of information is faster and quicker, and so the storytelling potential of data visualisation narratives is productive. During a global endemic like coronavirus, the mounting fear motivates people to seek accurate and credible information swifter and also change health behaviour accordingly. This paper tries to explore the representation of visualisation of data during the outbreak of global pandemic – COVID-19 for three months – from 1 January to 21 March 2020 in two leading national newspapers – The Hindu and The Times of India. The study identified the percentage of coverage, different levels and types of infographics and message characteristics of infographics. The study found that response and self-efficacy related infographics were primarily less in number compared to severity and vulnerability. Media needs to adorn a robe of „social responsibility‟ especially during a global pandemic like coronavirus, which is sweeping across the globe – as visual message tend to have more impact than the text.

Alqeisi K., Abbad M., Abosalem Y.

Kong H., Zainab F., Turner A.M., Bekemeier B., Backonja U.

Bashir R., Yasmin M.

Abstract The COVID-19 pandemic has transformed the ideological, social, economic, and political aspects of life on planet Earth. This study examines the visuals associated with COVID-19 published in Pakistani English newspapers. Visual data were collected through purposive sampling, analyzed using social semiotic theory, and discussed through a post-colonial lens. The visual data were grouped as Global South and North owing to socioeconomic and political categorization among countries. The results show that the Pakistani media portrayed the Global South as rebellious, miserable, and noisy against the government. However, the Global North is depicted as civilized, stress-free, and abiding by all the instructions of the authority. Analysis shows that the two realms are visually represented as remarkably divergent from each other, and media portrayal has attached stereotypes identities to the nations. Pakistani media follows a basic restricted code of conduct, which should be extended to avoid labelling and politicizing groups and nations.

Dix A., Bond R., Caraban A.

Abstract This paper draws on diverse psychological, behavioural and numerical literature to understand some of the challenges we all face in making sense of large-scale phenomena and use this to create a road map for HCI responses. This body of knowledge offers tools and principles that can help HCI researchers deliver value now, but also highlights challenges for future HCI research. The paper is framed by looking at patterns and information that highlight some of the common misunderstandings that arise—not just for politicians and the general public but also for many in the academic community. This paper does not have all the answers to this, but we hope it provides some and, perhaps more importantly, raises questions that we need to address as scientific and technical communities.

Adi D., Setiautami D.

Combination of visual and text to deliver information that simply called Infographic, allows the reader to easily comprehend complex information, in this case, delivering information about the Covid-19 pandemic in Indonesia and how to cope with the condition. This paper will be started with explanation about the pandemic and how Infographics became a medium to deliver the information. Then, this paper will be discussed how Infographics are used to deliver information on Instagram, popular social media, in order to guide the audience in preparing for the outbreak and built awareness about the global pandemic. At the end, a clearer picture of how Infographic contribute to delivering information and building awareness to a wide range of audiences can be obtained, at the same time the difference in the visual approach implemented at the beginning of the pandemic and after the relaxation of social interactions in public spaces toward the “New Normal” are explained.

Lopezosa C., Pérez-Montoro M., Guallar J.

Data visualization is applied intensively in the digital news media where it serves as an effective tool for storytelling and for facilitating explanations of complex or data-intensive information. However, research and theoretical studies of this type of narrative lag badly behind in terms of both their volume and importance. It is in response to this failure to keep pace that this chapter seeks to review academic and scientific production dedicated to understanding the news media, data visualization and, more specifically, information visualization, infographics, visual narratives, and visual storytelling. In so doing, our aims are to, first, delimit the state of the art of this discipline; second, describe emerging trends and the challenges faced when seeking to deploy data visualization, at the same time as identifying the technologies and protocols being employed to this end; and, third, determine the possibilities and limitations of its use for communication and journalism. We find that recent studies have focused primarily on infographics, data journalism, structured journalism, media literacy and the reader’s interpretation of visual data, the exploitation of visualization in the digital media, and visual analytics. Studies of data visualization technologies and tools have shown an interest above all in the application of big data strategies within the news media, as well as in the development of software and tools of visual analysis. Finally, our scientific database revealed a number of studies dedicated to visual analytics, the specific challenges faced, and the decision-making processes involved.

Klein-Avraham I., Reich Z.

Kemp D., King A.J., Upshaw S.J., Mackert M., Jensen J.D.

We propose that harm reduction messages advocating moderation versus abstinence from social interaction will be seen as less threatening and increase intentions to follow COVID-19 guidelines. We also examine two important moderators: the influence of risk framing and willingness to risk infection.

Rodionova Y.V.

In September 2021, the Russian Society for the Prevention of Noncommunicable Diseases published a practical guideline “Promoting the research results using infographic tools and graphical summaries”, which describes data visualization in research articles. The use of infographics in scientific articles becomes more and more popular. Therefore, researchers began to ask more often: how to create a graphical summary or a short presentation with the research results? The article outlines the basic principles of graphical data representation that will help authors in preparing publications. 

Falisse J., McAteer B.

Data visualisations are intimately connected to the emergence of public health as a discipline and policy area. Besides the mapping of cases and deaths, the COVID-19 pandemic has seen an explosion of attempts to track policy responses. They have come from actors sometimes initially unfamiliar with public and global health. In this paper, we analyse seven of the most successful tracker initiatives that have sought to map governments’ reactions to COVID-19 and reflect on our own. When not led by international organisations, the trackers primarily rely on networks of volunteer country expert contributors (who need to be incentivised in the medium term). The vertical crowdsourcing approach means that, despite good intentions, contributors have a relatively limited agency in shaping the trackers. Maps and timelines comparing countries are the most popular visualisations; they suggest that (some) policy solutions can be found abroad and rely on policy taxonomies established by the trackers’ core teams. We contend that such taxonomies, which compete with each other, constitute attempts to frame the complex issue of which policies matter in responding to COVID-19. All the projects are large and complex and often without a well-defined intended audience. We hypothesise that the popularity (in terms of backlinks) of the most successful tracker arises from the fact that it sums up COVID-19 policies in one easily visualisable indicator. We suggest that the trackers are a more helpful emergency policy tool when they provide contextual information, keep policy details or refer to them (rather than only reduce them to categories), and suggest ways to link different elements—including the relationship between health or societal outcomes and policies.

Samra E.M.

During the COVID-19 pandemic, this study sought to determine the impact of AI-supported infographic templates (static versus animated) on academic achievement, visual thinking skills, and willingness to learn among a sample of university students. The researcher created two distinct AI-supported instructional infographic templates to determine the effect of such an independent variable on his three other primary dependent variables, namely, academic accomplishment, visual thinking skills, and willingness to learn, in order to meet his study goals. An achievement exam, a visual thinking test, and a willingness to learn scale were among the research methods used. The quasiexperimental method was used to provide the research instruments, and experimental therapy was used to a select group of students at Umm Al-Qura University. According to the findings, AI-assisted static and animated infographic templates had a favorable impact on the development of all learning aspects studied. AI-assisted animated infographics, on the other hand, had a more significant impact than AI-assisted static infographics. In light of this, the researcher concluded his research by making a number of recommendations and suggesting additional research, such as maximizing the use of AI emerging technologies and their practical application in an adaptive manner suitable for education.

Freixa P., Pérez-Montoro M., Codina L.

Interaction and visualization together yield an interesting, fruitful, and promising combination for producing content in digital news media. In an era in which the press no longer exclusively provides the news, interaction and visualization combined in innovative products for the public are powerful value propositions for the media. Together, they are capable of winning readers’ loyalty and engagement, both of which are crucial for the media’s sustainability. In this work, we present a review of the literature and formulate the theoretical bases for this binomial pairing and its main components, which, we argue, should be available to citizens, the interests of whom journalism must defend if it aspires to be viable.

Paropkari A.

Kebede M.M., Pischke C.R.

Introduction: Evidence on whether diabetes apps improve diabetes self-care behavior in real-world settings is still limited. This study aimed to identify popular diabetes applications (apps) and to investigate the association of diabetes app use and other factors with cumulative self-care behavior. Methods: From November 2017 to March 2018, we conducted a web-based survey with persons 18 years of age and above. We recruited respondents via diabetes Facebook groups, online patient-forums and targeted Facebook advertisements (ads). Data on participants’ demographic, clinical, and self-management characteristics, as well as on self-care behavior and characteristics of the diabetes apps use were collected. Self-care behavior was measured using a licensed version of the Summary of Diabetes Self-care Activities (SDSCA) questionnaire. Questions regarding diabetes smartphone applications were adapted from the Mobile Application Rating Scale. To identify popular diabetes apps, users were requested to list all apps they use for diabetes self-management. Two sample t-test and multiple linear regression stratified by type of diabetes were performed to examine associations between app use and self-care behavior. Results: 1052 respondents with type 1 and 630 respondents with type 2 diabetes mellitus (DM) entered the survey. More than half, 549(52.2%), and one third, 210(33.3%), of respondents with type 1 and 2 DM, respectively, reported using diabetes apps for self-management. “mySugar” and continuous glucose monitoring apps, such as “Dexcom”, “Freestyle Libre”, and “Xdrip+” were some of the most popular diabetes apps. In both respondent groups, the cumulative self-care behavior score was significantly higher among diabetes app users (compared to non-users) and scores for three individual self-care components, namely “blood glucose monitoring”, “general diet”, and “physical activity” were significantly higher among diabetes app users than among non-users. After adjusting for confounding factors, diabetes app use increased the cumulative self-care score by 1.08(95%CI: 0.46-1.7) units among persons with type 1 DM and by 1.18(95%CI: 0.26 – 2.09) units among persons with type 2 DM, respectively. Conclusion: For both, persons with type 1 and type 2 diabetes, using diabetes apps for self-management was positively associated with self-care behavior. Our findings suggest that apps can support changes in lifestyle and glucose monitoring in these populations.

Jimenez G., Lum E., Car J.

Background The availability of smartphone health apps empowers people to manage their own health. Currently, there are over 300,000 health apps available in the market targeting a variety of user needs from weight loss to management of chronic conditions, with diabetes being the most commonly targeted condition. To date, health apps largely fall outside government regulation, and there are no official guidelines to help clinicians and patients in app selection. Patients commonly resort to the internet for suggestions on which diabetes app to use. Objective The objective of this study was to investigate apps identified through a Google search and characterize these apps in terms of features that support diabetes management. Methods We performed a Google search for the “best diabetes apps 2017” and explored the first 4 search results. We identified and compiled a list of the apps recommended in the returned search results, which were Web articles. Information about each app was extracted from the papers and corresponding app store descriptions. We examined the apps for the following diabetes management features: medication management, blood glucose self-management, physical activity, diet and nutrition, and weight management. Results Overall, 26 apps were recommended in 4 papers. One app was listed in all 4 papers, and 3 apps appeared on 3 of the 4 lists. Apart from one paper, there were no explicit criteria to justify or explain the selection of apps. We found a wide variation in the type and the number of diabetes management features in the recommended apps. Five apps required payment to be used. Two-thirds of the apps had blood glucose management features, and less than half had medication management features. The most prevalent app features were nutrition or diet-related (19/24, 79%) and physical activity tracking (14/24, 58%). Conclusions The ambiguity of app selection and the wide variability in key features of the apps recommended for diabetes management may pose difficulties for patients when selecting the most appropriate app. It is critical to involve patients, clinicians, relevant professional bodies, and policy makers to define the key features an app should have for it to be classified as a “diabetes management” app. The lessons learned here may be extrapolated for the development and recommendation of apps for the management of other chronic conditions.

Paglialonga A., Lugo A., Santoro E.

• Identification, characterization, and assessment of health apps are open problems. • Various resources for identification can be found on the web or literature. • Several methods for app characterization exist, based on several features. • Assessment of app quality requires the evaluation of several components. • There is a need for guiding principles and minimum requirements for app development. The need to characterize and assess health apps has inspired a significant amount of research in the past years, in search for methods able to provide potential app users with relevant, meaningful knowledge. This article presents an overview of the recent literature in this field and categorizes - by discussing some specific examples - the various methodologies introduced so far for the identification, characterization, and assessment of health apps. Specifically, this article outlines the most significant web-based resources for app identification, relevant frameworks for descriptive characterization of apps’ features, and a number of methods for the assessment of quality along its various components (e.g., evidence base, trustworthiness, privacy, or user engagement). The development of methods to characterize the apps’ features and to assess their quality is important to define benchmarks and minimum requirements. Similarly, such methods are important to categorize potential risks and challenges in the field so that risks can be minimized, whenever possible, by design. Understanding methods to assess apps is key to raise the standards of quality of health apps on the market, towards the final goal of delivering apps that are built on the pillars of evidence-base, reliability, long-term effectiveness, and user-oriented quality.

Bol N., Helberger N., Weert J.C.

This article provides a more differentiated understanding of mobile health consumers, and considers whether health app use may contribute to new digital inequalities. It focuses on factors associat...

Chavez S., Fedele D., Guo Y., Bernier A., Smith M., Warnick J., Modave F.

Approximately 29 million Americans are diagnosed with diabetes. The increased prevalence of type 2 diabetes (T2D) and required intensity of disease management programs are straining health systems, especially in primary care where physicians often lack adequate time with patients. Mobile technologies (e.g., smartphones, wearable devices) provide highly scalable new approaches to T2D management. Approximately 77% of American adults have access to a smartphone regardless of socioeconomic status or ethnicity (1), and more than 50% of smartphone owners use their mobile devices to obtain health information (2). However, mobile health (mHealth) applications (apps) have been found to lack evidence-based support when functionalities and information provided in apps are compared with clinical guidelines for specific disease management (3). The objective of this study was to assess whether popular apps for diabetes management were of sufficient quality to complement clinical care. We used the Mobile App Rating Scale (MARS) (4), a reliable and validated scoring instrument of mHealth app quality, to assess the quality of the most popular free …

Holmen H., Wahl A.K., Cvancarova Småstuen M., Ribu L.

The prevalence of diabetes is increasing and with the requirements for self-management and risk of late complications, it remains a challenge for the individual and society. Patients can benefit from support from health care personnel in their self-management, and the traditional communication between patients and health care personnel is changing. Smartphones and apps offer a unique platform for communication, but apps with integrated health care personnel communication based on patient data are yet to be investigated to provide evidence of possible effects.Our goal was to systematically review studies that aimed to evaluate integrated communication within mobile apps for tailored feedback between patients with diabetes and health care personnel in terms of (1) study characteristics, (2) functions, (3) study outcomes, (4) effects, and (5) methodological quality.A systematic literature search was conducted following our International Prospective Register of Systematic Reviews (PROSPERO) protocol, searching for apps with integrated communication for persons with diabetes tested in a controlled trial in the period 2008 to 2016. We searched the databases PubMed, Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central, Excerpta Medica database (EMBASE), ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform. The search was closed in September 2016. Reference lists of primary articles and review papers were assessed. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and we applied the Cochrane risk of bias tool to assess methodological quality.We identified 2822 citations and after duplicate removal, we assessed 1128 citations. A total of 6 papers were included in this systematic review, reporting on data from 431 persons participating in small trials of short duration. The integrated communication features were mostly individualized as written non-real-time feedback. The number of functions varied from 2 to 9, and blood glucose tracking was the most common. HbA1c was the most common primary outcome, but the remaining reported outcomes were not standardized and comparable. Because of both the heterogeneity of the included trials and the poor methodological quality of the studies, a meta-analysis was not possible. A statistically significant improvement in the primary measure of outcome was found in 3 of the 6 included studies, of which 2 were HbA1c and 1 was mean daytime ambulatory blood pressure. Participants in the included trials reported positive usability or feasibility postintervention in 5 out of 6 trials. The overall methodological quality of the trials was, however, scored as an uncertain risk of bias.This systematic review highlights the need for more trials of higher methodological quality. Few studies offer an integrated function for communication and feedback from health care personnel, and the research field represents an area of heterogeneity with few studies of highly rigorous methodological quality. This, in combination with a low number of participants and a short follow-up, is making it difficult to provide reliable evidence of effects for stakeholders.

Kayyali R., Peletidi A., Ismail M., Hashim Z., Bandeira P., Bonnah J.

Purpose: Mobile health (mHealth) solutions have become an inevitable element of the healthcare landscape. The recommendation and use of mHealth is important, but it is often underutilised. This study was conducted in England. It aimed to determine the use and recommendation of mHealth apps by pharmacists, the public’s perceptions of mHealth apps in general, and the awareness and use of health apps by diabetic patients in particular. Methods: The study used a mixed research approach, utilising a sequence of survey-based questionnaires with pharmacists and the general public, followed by semi-structured interviews with diabetic patients. Results: Pharmacists’ questionnaires revealed that 56% of the respondents were aware of health apps, 60% of which recommended them to patients. Over 76% of the individuals owned a smartphone. The types of applications that saw the most use from the general public were health and lifestyle apps (24%), social apps (19%), followed by news (18%). Although eight out of nine diabetic patients owned a smartphone, only three used diabetes apps. Diabetic patients also suggested an interest in using diabetes apps to aid in optimising care via the utilisation of visual aids, reminders, recording patient data, social coaching, and remote collaboration with healthcare professionals (HCPs), but time was seen as the biggest obstacle to using a diabetes mHealth application. Conclusion: Despite the growing number of mHealth apps, the level of awareness and usability of such apps by patients and pharmacists was still relatively low. Nevertheless, the majority who used health apps found them to be beneficial, and the public agreed that it helped them to live a healthier lifestyle. Therefore, health apps have great potential in health promotion. Pharmacists are ideally placed to promote them and make patients more aware of them. To increase the use of these apps, it is necessary to first increase awareness and knowledge of these apps, both to the public and to healthcare professionals.

Lithgow K., Edwards A., Rabi D.

Finding novel ways to engage patients in chronic disease management has led to increased interest in the potential of mobile health technologies for the management of diabetes. There is currently a wealth of smartphone apps for diabetes management that are available for free download or purchase. However, the usability and desirability of these apps has not been extensively studied. These are important considerations, as these apps must be accepted by the patient population at a practical level if they are to be utilized.The purpose of this study was to gain insight into patient experiences related to the use of smartphone apps for the management of type 1 diabetes.Adults with type 1 diabetes who had previously (or currently) used apps to manage their diabetes were eligible to participate. Participants (n=12) completed a questionnaire in which they were required to list the names of preferred apps and indicate which app functions they had used. Participants were given the opportunity to comment on app functions that they perceived to be missing from the current technology. Participants were also asked whether they had previously paid for an app and whether they would be willing to do so.MyFitnessPal and iBGStar were the apps most commonly listed as the best available on the market. Blood glucose tracking, carbohydrate counting, and activity tracking were the most commonly used features. Ten participants fulfilled all eligibility criteria, and indicated that they had not encountered any one app that included all of the functions that they had used. The ability to synchronize an app with a glucometer or insulin pump was the most common function that participants stated was missing from current app technology. One participant had previously paid for a diabetes-related app and the other 9 participants indicated that they would be willing to pay.Despite dissatisfaction with the currently available apps, there is interest in using these tools for diabetes management. Adapting existing technology to better meet the needs of this patient population may allow these apps to become more widely utilized.

Cui M., Wu X., Mao J., Wang X., Nie M.

Background Mobile health interventions (mHealth) based on smartphone applications (apps) are promising tools to help improve diabetes care and self-management; however, more evidence on the efficacy of mHealth in diabetes care is needed. The objective of this study was to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) assessing the effect of mHealth apps on changes in hemoglobin A1c (HbA1c), blood glucose, blood pressure, serum lipids, and body weight in type 2 diabetes mellitus (T2DM) patients. Methods Two independent reviewers searched three online databases (PubMed, the Cochrane Library, and EMBASE) to identify relevant studies published between January 2005 and June 2016. Of the 2,596 articles retrieved, 13 RCTs were included. We used random effects model to estimate the pooled results. Results Thirteen studies were selected for the systematic review, six of which with data available containing 1,022 patients were included for the meta-analysis. There was a moderate effect on glycemic control after the mHealth app-based interventions. The overall effect on HbA1c shown as mean difference (MD) was -0.40% (-4.37 mmol/mol) (95% confidence interval [CI] -0.69 to -0.11% [-7.54 to -1.20 mmol/mol]; p = 0.007) and standardized mean differences (SMD) was -0.40% (-4.37 mmol/mol) (95% confidence interval [CI] -0.69 to -0.10% [-7.54 to -1.09 mmol/mol]; p = 0.008). A subgroup analysis showed a similar effect with -0.33% (-3.61 mmol/mol) (95% CI -0.59 to -0.06% [-6.45 to -0.66 mmol/mol]; p = 0.02) in MD and -0.38% (-4.15 mmol/mol) (95% CI -0.71 to -0.05% [-7.76 to -0.55 mmol/mol]; p = 0.02) in SMD in studies where patients’ baseline HbA1c levels were less than 8.0%. No effects of mHealth app interventions were found on blood pressure, serum lipids, or weight. Assessment of overall study quality and publication bias demonstrated a low risk of bias among the six studies. Conclusions Smartphone apps offered moderate benefits for T2DM self-management. However, more research with valid study designs and longer follow-up is needed to evaluate the impact of mHealth apps for diabetes care and self-management.

Müller A.M., Alley S., Schoeppe S., Vandelanotte C.

Promoting physical activity and healthy eating is important to combat the unprecedented rise in NCDs in many developing countries. Using modern information-and communication technologies to deliver physical activity and diet interventions is particularly promising considering the increased proliferation of such technologies in many developing countries. The objective of this systematic review is to investigate the effectiveness of e-& mHealth interventions to promote physical activity and healthy diets in developing countries. Major databases and grey literature sources were searched to retrieve studies that quantitatively examined the effectiveness of e-& mHealth interventions on physical activity and diet outcomes in developing countries. Additional studies were retrieved through citation alerts and scientific social media allowing study inclusion until August 2016. The CONSORT checklist was used to assess the risk of bias of the included studies. A total of 15 studies conducted in 13 developing countries in Europe, Africa, Latin-and South America and Asia were included in the review. The majority of studies enrolled adults who were healthy or at risk of diabetes or hypertension. The average intervention length was 6.4 months, and text messages and the Internet were the most frequently used intervention delivery channels. Risk of bias across the studies was moderate (55.7 % of the criteria fulfilled). Eleven studies reported significant positive effects of an e-& mHealth intervention on physical activity and/or diet behaviour. Respectively, 50 % and 70 % of the interventions were effective in promoting physical activity and healthy diets. The majority of studies demonstrated that e-& mHealth interventions were effective in promoting physical activity and healthy diets in developing countries. Future interventions should use more rigorous study designs, investigate the cost-effectiveness and reach of interventions, and focus on emerging technologies, such as smart phone apps and wearable activity trackers. The review protocol can be retrieved from the PROSPERO database (Registration ID: CRD42015029240 ).

McMillan K.A., Kirk A., Hewitt A., MacRury S.

Aim: The aim was to review studies examining the effectiveness, acceptability, and feasibility of mobile-based technology for promoting active lifestyles in people with type 2 diabetes (T2D). Background: Benefits of leading an active lifestyle following a diagnosis of T2D, including improved glycemic control, have been reported. Studies examining the specific use of mobile-based technologies to promote an active lifestyle in T2D have not previously been reviewed. Methods: Research studies examining effectiveness, feasibility or acceptability of mobile-based technology for active lifestyle promotion for T2D management were included (n = 9). The databases searched included PubMed, Medline, ScienceDirect, and ACM Digital Library (January 2005 to October 2015). Studies were categorized as (1) informing, (2) monitoring, (3) provoking, or (4) sustaining behavior change. Results: Technologies used included smartphone or tablet apps, diabetes personal digital assistant, continuous glucose monitor and accelerometer, pedometer, and a website delivered by a smartphone. No articles examined the effectiveness of mobile-based technology in monitoring health behaviors and behavior change. Four of the studies found mobile-based technology to be motivational and supportive for behavior change. The visual reinforcement was identified as motivational. The feasibility and acceptability of using mobile-based technology to provide sustained lifestyle change and the effectiveness of mobile-based technology in monitoring health behaviors and behavior change have not been investigated. No studies examined all 3 of the outcomes or focused decreasing the participants’ sedentary behavior. Conclusions: Limited research has examined the feasibility, acceptability, and effectiveness of mobile-based technology to promote active lifestyles and subsequently good diabetes management in people with T2D.

Whitehead L., Seaton P.

Long-term conditions and their concomitant management place considerable pressure on patients, communities, and health care systems worldwide. International clinical guidelines on the majority of long-term conditions recommend the inclusion of self-management programs in routine management. Self-management programs have been associated with improved health outcomes; however, the successful and sustainable transfer of research programs into clinical practice has been inconsistent. Recent developments in mobile technology, such as mobile phone and tablet computer apps, could help in developing a platform for the delivery of self-management interventions that are adaptable, of low cost, and easily accessible.We conducted a systematic review to assess the effectiveness of mobile phone and tablet apps in self-management of key symptoms of long-term conditions.We searched PubMed, Embase, EBSCO databases, the Cochrane Library, and The Joanna Briggs Institute Library for randomized controlled trials that assessed the effectiveness of mobile phone and tablet apps in self-management of diabetes mellitus, cardiovascular disease, and chronic lung diseases from 2005-2016. We searched registers of current and ongoing trials, as well as the gray literature. We then checked the reference lists of all primary studies and review papers for additional references. The last search was run in February 2016.Of the 9 papers we reviewed, 6 of the interventions demonstrated a statistically significant improvement in the primary measure of clinical outcome. Where the intervention comprised an app only, 3 studies demonstrated a statistically significant improvement. Interventions to address diabetes mellitus (5/9) were the most common, followed by chronic lung disease (3/9) and cardiovascular disease (1/9). A total of 3 studies included multiple intervention groups using permutations of an intervention involving an app. The duration of the intervention ranged from 6 weeks to 1 year, and final follow-up data ranged from 3 months to 1 year. Sample size ranged from 48 to 288 participants.The evidence indicates the potential of apps in improving symptom management through self-management interventions. The use of apps in mHealth has the potential to improve health outcomes among those living with chronic diseases through enhanced symptom control. Further innovation, optimization, and rigorous research around the potential of apps in mHealth technology will move the field toward the reality of improved health care delivery and outcomes.

Broadbent E., Wilkes C., Koschwanez H., Weinman J., Norton S., Petrie K.J.

Objective: This paper aims to systematically review the use and performance of the Brief Illness Perception Questionnaire (Brief IPQ). Design: Electronic databases were searched for papers administering the Brief IPQ published in peer-reviewed journals. Data were extracted from the results for meta-analysis. Main outcome measures: Use by illness population, country, language and study design. The questionnaire’s concurrent validity, predictive validity, sensitivity to change, discriminant validity and mean scores for different populations were summarised. Results: The review included 188 papers. The Brief IPQ has been administered to patients from age 8 to over 80, with a wide range of illnesses, in 26 languages from 36 countries. Pooled correlations between illness perceptions and depression, anxiety, blood glucose levels and quality of life were consistent with previous research and theory (range .25–.49 for consequences, identity and emotional representations; −.12 to −.27 for personal control). All items were able to predict some outcomes up to one-year follow-up. Each subscale demonstrated sensitivity to change after intervention in randomised controlled trials with the personal control and causal items showing most frequent change. Conclusions: The Brief IPQ is widely used and has good psychometric properties. More studies should include and analyse the causal item.

Lee J.

Mobile health applications (apps) created to help improve type 1 diabetes or type 2 diabetes care are perceived by their visionaries and programmers as game-changing tools which assist in the rigorous demands of diabetes self-management. People living with diabetes who have access to mobile technology are learning how to utilise technology for better blood glucose control and support, often in conjunction with their healthcare teams. Despite all the technological progress and success, diabetes health apps also raise concerns about important issues such as regulation and approval, privacy, accuracy and safety. In a shortened review, Joyce Lee, Associate Professor of Pediatrics at the University of Michigan and Co-Director of the Mott Mobile Technology Program for Enhancing Child Health assesses the types of endocrinology and diabetes apps available today and examines current challenges that so often come with new technologies.