Parental Perceptions of Priorities and Features for a Mobile App to Promote Healthy Lifestyle Behaviors in Preschool Children: Mixed Methods Evaluation.

Background: Parents of preschool-aged children are a key focus for interventions to shape healthy lifestyle behaviors and support risk reduction for obesity from an early age. In light of limited existing evidence on the use of mobile technology to promote healthy lifestyle behaviors among young children, we sought to gather parental priorities regarding a mobile app focused on guided goal setting across the domains of diet, physical activity, media use, and sleep.

Objective: The purpose of this study was to explore the priorities and needs of parents of 2- to 5-year-old children to guide developing the content and features of a mobile app aimed at promoting healthy lifestyle behaviors using a novel convergent mixed methods approach.

Satisfaction and Usability of a Commercially Available Medication Adherence App (Medisafe) Among Medically Underserved Patients With Chronic Illnesses: Survey Study.

Background: Research supports the use of mobile phone apps to promote medication adherence, but the use of and satisfaction with these apps among medically underserved patients with chronic illnesses remain unclear.

Objective: This study reports on the overall use of and satisfaction with a medication adherence app (Medisafe) in a medically underserved population.

Methods: Medically underserved adults who received care for one or more chronic illnesses at a federally qualified health center (FQHC) were randomized to an intervention group in a larger randomized controlled trial and used the app for 1 month (n=30), after which they completed a web-based survey.

Effects of a medication adherence app among medically underserved adults with chronic illness: a randomized controlled trial.

For individuals living with a chronic illness who require use of long-term medications, adherence is a vital aspect of successful symptom management and outcomes. This study investigated the effect of a smartphone app on adherence, self-efficacy, knowledge, and medication social support in a medically underserved adult population with various chronic illnesses. Participants were randomized to a group who used the app for one month or a control group provided with a printed medication list.

A Digital Platform to Support HIV Case Management for Youth and Young Adults: Mixed Methods Feasibility Study.

Background: Advances in medical treatments in recent years have contributed to an overall decline in HIV-related opportunistic infections and deaths in youth; however, mortality and morbidity rates in perinatally and nonperinatally infected adolescents and young adults (AYA) living with HIV remain relatively high today.

Objective: The goal of this project was to assess the use, utility, and cost-effectiveness of PlusCare, a digital app for HIV case management in AYA living with HIV. The app supports routine case management tasks, such as scheduling follow-up visits, sharing documents for review and signature, laboratory test results, and between-visit communications (eg, encouraging messages).

Help when you need it: Perspectives of adults with T1D on the support and training they would have wanted when starting CGM.

Aims: The purpose of this study was to explore preferences that adults with type 1 diabetes (T1D) have for training and support to initiate and sustain optimal use of continuous glucose monitoring (CGM) technology.

Methods: Twenty-two adults with T1D (M age 30.95 ± 8.

Prioritization of Features for Mobile Apps for Families in a Federal Nutrition Program for Low-Income Women, Infants, and Children: User-Centered Design Approach.

Background: The Special Supplemental Nutrition Assistance Program for Women, Infants, and Children (WIC) is a federal nutrition program that provides nutritious food, education, and health care referrals to low-income women, infants, and children up to the age of 5 years. Although WIC is associated with positive health outcomes for each participant category, modernization and efficiency are needed at the clinic and shopping levels to increase program satisfaction and participation rates. New technologies, such as electronic benefits transfer (EBT), online nutrition education, and mobile apps, can provide opportunities to improve the WIC experience for participants.

Multisite Examination of Depression Screening Scores and Correlates Among Adolescents and Young Adults With Type 2 Diabetes.

Objectives: Our aim was to evaluate self-reported depressive symptoms and clinical outcomes during routine screening for adolescents and young adults with type 2 diabetes (T2D), and examine associations among depressive symptoms and demographic and clinical characteristics.

Methods: The Patient Health Questionnaire (PHQ) was administered to 197 adolescents and young adults with T2D using the PHQ-2 or PHQ-9 in routine pediatric diabetes care at 4 academic medical centres. Data from electronic health records were extracted from the screening date and 12 months earlier.

Transplantation and Adherence: Evaluating Tacrolimus Usage in Pediatric Patients With Cancer.

Background: Researchers have estimated that about 50% of pediatric patients with chronic illness adhere to tacrolimus therapy, a medication responsible for preventing critical side effects in patients undergoing hematopoietic stem cell transplantation (HSCT).

Objectives: The purpose of this study was to describe patient adherence to tacrolimus by reviewing documentation from the electronic health record and therapeutic drug levels.

Methods: This retrospective descriptive study examined 357 clinic visits by 57 patients undergoing HSCT.

A retrospective multisite examination of depression screening practices, scores, and correlates in pediatric diabetes care.

Psychosocial guidelines recommend routine screening of depressive symptoms in adolescents and young adults (AYA) with diabetes. Best practices for screening in routine care and patient characteristics associated with depressive symptoms require further investigation. The purpose of this study was to examine psychometric properties of the Patient Health Questionnaire (PHQ-2 and PHQ-9); document rates of depressive symptoms and related clinical actions; and evaluate associations with patient characteristics.

A mobile app identifies momentary psychosocial and contextual factors related to mealtime self-management in adolescents with type 1 diabetes.

Effective diabetes problem solving requires identification of risk factors for inadequate mealtime self-management. Ecological momentary assessment was used to enhance identification of factors hypothesized to impact self-management. Adolescents with type 1 diabetes participated in a feasibility trial for a mobile app called MyDay.

The Medication Level Variability Index (MLVI) as a potential predictive biomarker of graft-versus-host disease in pediatric hematopoietic stem cell transplant patients.

The purpose of this study was to examine the potential predictive value of the Medication Level Variability Index (MLVI) biomarker with graft-versus-host disease (GVHD) in the pediatric hematopoietic stem cell transplant (HSCT) patient during the acute phase post-transplant. This retrospective descriptive study evaluated a total of 406 tacrolimus levels in 64 patients over a varying number of weeks per participant (median = 8, min = 3, max = 11). Patients were followed until Day 100 post-transplant or tacrolimus taper began.

Mobile Momentary Assessment and Biobehavioral Feedback for Adolescents with Type 1 Diabetes: Feasibility and Engagement Patterns.

Background: Integration of momentary contextual and psychosocial factors within self-management feedback may provide more specific, engaging, and personalized targets for problem solving.

Methods: Forty-four youth ages 13-19 with type 1 diabetes (T1D) were provided a Bluetooth meter and completed the 30-day protocol. Participants were randomized to "app + meter" or "meter-only" groups.

A Smartphone App for Families With Preschool-Aged Children in a Public Nutrition Program: Prototype Development and Beta-Testing.

Background: The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in the United States provides free supplemental food and nutrition education to low-income mothers and children under age 5 years. Childhood obesity prevalence is higher among preschool children in the WIC program compared to other children, and WIC improves dietary quality among low-income children. The Children Eating Well (CHEW) smartphone app was developed in English and Spanish for WIC-participating families with preschool-aged children as a home-based intervention to reinforce WIC nutrition education and help prevent childhood obesity.

Optimal Use of Diabetes Devices: Clinician Perspectives on Barriers and Adherence to Device Use.

Background: Insulin pumps and continuous glucose monitors (CGM) can improve glycemic control for individuals with type 1 diabetes (T1D). Device uptake rates continue to show room for improvement, and consistent adherence is needed to achieve better outcomes. Diabetes health care providers have important roles to play in promoting device use and adherence.

Sharing and helping: predictors of adolescents' willingness to share diabetes personal health information with peers.

Objective: Sharing personal information about type 1 diabetes (T1D) can help adolescents obtain social support, enhance social learning, and improve self-care. Diabetes technologies, online communities, and health interventions increasingly feature data-sharing components. This study examines factors underlying adolescents' willingness to share personal T1D information with peers.

mHealth Intervention Elements and User Characteristics Determine Utility: A Mixed-Methods Analysis.

Background: Mobile health (mHealth) interventions are improving the medication adherence of adults with type 2 diabetes mellitus (T2DM), but few studies examine how users experience these interventions. Therefore, we used a mixed-methods approach to understand how T2DM users experience a text messaging and interactive voice response (IVR)-delivered medication adherence intervention called MEssaging for Diabetes (MED).

Methods: Adults with T2DM used MED as part of a 3-month pilot study.

The MEssaging for Diabetes Intervention Reduced Barriers to Medication Adherence Among Low-Income, Diverse Adults With Type 2.

Background: Nonadherence to diabetes medication is prevalent and costly. MEssaging for Diabetes (MED), a mobile health (mHealth) intervention, identified and addressed user-specific barriers to medication adherence. We assessed whether MED reduced users' targeted barriers and if barrier reductions were associated with within-participant improvements in adherence or glycemic control (HbA1c).

The MEssaging for Diabetes (MED) intervention improves short-term medication adherence among low-income adults with type 2 diabetes.

Adults with type 2 diabetes (T2DM) and low socioeconomic status (SES) have high rates of medication nonadherence, and, in turn, suboptimal glycemic control (hemoglobin A1c [HbA1c]). We tested the initial efficacy of a short message service (SMS) text messaging and interactive voice response (IVR) intervention to promote adherence among this high-risk group. Eighty low SES, diverse adults with T2DM used the MEssaging for Diabetes (MED) SMS/IVR intervention for 3 months.

Use of Commonly Available Technologies for Diabetes Information and Self-Management Among Adolescents With Type 1 Diabetes and Their Parents: A Web-Based Survey Study.

Background: For individuals with Type 1 diabetes (T1D), following a complicated daily medical regimen is critical to maintaining optimal health. Adolescents in particular struggle with regimen adherence. Commonly available technologies (eg, diabetes websites, apps) can provide diabetes-related support, yet little is known about how many adolescents with T1D use them, why they are used, or relationships between use and self-management.

The feasibility of text reminders to improve medication adherence in adolescents with asthma.

Objective: Personal health applications have the potential to help patients with chronic disease by improving medication adherence, self-efficacy, and quality of life. The goal of this study was to assess the impact of MyMediHealth (MMH) - a website and a short messaging service (SMS)-based reminder system - on medication adherence and perceived self-efficacy in adolescents with asthma.

Methods: We conducted a block-randomized controlled study in academic pediatric outpatient settings.

Technology and the Ecology of Chronic Illness in Everyday Life.

A major challenge in the design of useful technological tools is effectively conceptualizing the context in which users engage the technology. Contextually specific research on activities of patients and their caregivers - and how those activities are supported by social and material arrangements--can result in insights for design of consumer health informatics technologies and infrastructural advancements that can better support patients outside of institutional settings. This chapter describes an ecosystem focused on activity--how activity is shaped by cultural institutions, and the negotiations that arise between actors and institutions.

Disparities in the use of a mHealth medication adherence promotion intervention for low-income adults with type 2 diabetes.

Objective: Mobile health (mHealth) interventions may improve diabetes outcomes, but require engagement. Little is known about what factors impede engagement, so the authors examined the relationship between patient factors and engagement in an mHealth medication adherence promotion intervention for low-income adults with type 2 diabetes (T2DM).

Materials And Methods: Eighty patients with T2DM participated in a 3-month mHealth intervention called MEssaging for Diabetes that leveraged a mobile communications platform.