BACKGROUND: Adolescence was associated with suboptimal diabetes control. Studies supporting the use of mobile technology to improve glycemic control and adherence to treatment had mixed results.

OBJECTIVES: This study aimed to evaluate the effect of SMS reminders on improving glycemic control in adolescents with Type 1 Diabetes Mellitus (T1DM)

METHODOLOGY: A randomized control study among adolescents with poorly controlled type 1 diabetes mellitus was done. Data were processed from 56 out of 64 subjects who were randomized into control (N=29) who received standard of care and SMS group (N=27), who received standard of care and a daily SMS reminder regarding diabetes self-care for 12 weeks. An adherence form was answered by all participants and glycosylated hemoglobin (HbA1c) before and after intervention was compared.

RESULTS: HbA1c did not significantly differ between SMS and control groups after 12 weeks of intervention (SMS 9.98+2.12 vs control 10.54+2.13, p value of 0.305). Post intervention, there was no significant difference between SMS and control group in terms of adherence to insulin injection (no p value), blood glucose (BG) monitoring (p value 0.106), and diabetic diet (p value 0.803). However, adherence on exercise was significantly higher among control group than SMS group (p value 0.003).

CONCLUSION: A 12-week SMS intervention reminder in adolescents with type 1 diabetes mellitus did not significantly improve glycemic control and adherence to standard of care (insulin injection, blood glucose monitoring, diet and exercise).

RECOMMENDATION: Future researches could include a bigger study population and longer duration of intervention. Other forms of mobile technology could also be used as a form of reminder.

Human ; Male ; Female ; Child: 6-12 Yrs Old ; Adolescent: 13-18 Yrs Old ; Diabetes Mellitus ; Diabetes Mellitus, Type 1 ; Text Messaging ; Glycated Hemoglobin ; Therapeutics ; Technology ; Standard Of Care ; Self Care

Introduction: Digital device helps children enhance academic, cognitive and psychomotor skills. However, prolonged use causes physical inactivity, poor interpersonal skills and communication problems. Information on digital device use among young children in Malaysia is currently limited. Hence, this study aimed to determine the prevalence of digital device utilisation among preschool children in Kota Setar District, Kedah. Methods: A cross-sectional study at government preschools in Kota Setar District was conducted from February to April 2020. Selection of preschools and students was done using multistage simple randomisation. A self-administered questionnaire containing demographic and digital device use details was filled by parents. Results: The prevalence of digital device use among preschool children was 95.9% and mostly used smartphones (94.2%). Most children (95%) did not own the device, and usage was under supervision (95.7%). The reason for supervision was to prevent exposure to inappropriate content (70.5%). The common reasons for allowing digital device use were for educational (37.4%) and entertainment purposes (36%) through videos (30.9%) and games (30.2%). Approximately 21.5% and 50.3% of the children spent more than 1 and 2 hours on digital devices during weekdays and weekends, respectively. Conclusion The prevalence of digital device use among the preschool children in Kota Setar District was very high. Most of them used digital devices for educational and entertainment purposes under parental supervision. However, some exceeded the recommended screen time on weekends. These findings could promote awareness of digital device use among young children and help design public health awareness programmes and future policies.
Child ; Child, Preschool ; Prevalence ; Smartphone ; Screen time

BACKGROUND: To combat coronavirus disease 2019 (COVID-19), many countries have used contact tracing apps, including Japan's voluntary-use contact-confirming application (COCOA). The current study aimed to identify industry and workplace characteristics associated with the downloading of this COVID-19 contact tracing app. METHODS: This cross-sectional study of full-time workers used an online survey. Multiple logistic regression analysis was used to evaluate the associations of industry and workplace characteristics with contact tracing app use. RESULTS: Of the 27,036 participants, 25.1% had downloaded the COCOA. Workers in the public service (adjusted odds ratio [aOR] = 1.29, 95% confidence interval [CI] 1.14-1.45) and information technology (aOR = 1.38, 95% CI 1.20-1.58) industries were more likely to use the app than were those in the manufacturing industry. In contrast, app usage was less common among workers in the retail and wholesale (aOR = 0.87, 95% CI 0.76-0.99) and food/beverage (aOR = 0.81, 95% CI 0.70-0.94) industries, but further adjustment for company size attenuated these associations. Workers at larger companies were more likely to use the app. Compared with permanent employees, the odds of using the app were higher for managers and civil servants but lower for those who were self-employed. CONCLUSIONS Downloading of COCOA among Japanese workers was insufficient; thus, the mitigating effect of COCOA on the COVID-19 pandemic is considered to be limited. One possible reason for the under-implementation of the contact tracing app in the retail and wholesale and food/beverage industries is small company size, as suggested by the fully adjusted model results. An awareness campaign should be conducted to promote the widespread use of the contact tracing app in these industries.
Adult ; COVID-19/prevention & control* ; Contact Tracing/methods* ; Cross-Sectional Studies ; Female ; Humans ; Industry/classification* ; Japan/epidemiology* ; Male ; Middle Aged ; Mobile Applications/statistics & numerical data* ; SARS-CoV-2 ; Smartphone ; Workplace/statistics & numerical data*

Cardiomyopathy, Hypertrophic/genetics* ; Female ; Genetic Testing ; Humans ; Pregnancy ; Text Messaging

PURPOSE: This study aimed to develop a smartphone overdependence prevention program for college students based on the self-determination theory (SDT) and evaluate its effectiveness.METHODS: A non-equivalent control group repeated measures design was used for the study. Participants were 64 university freshmen (experimental group: 29, control group: 35). The developed program consists of eight sessions conducted twice a week. The program was designed to promote autonomy, competence, and relatedness the three elements of the basic psychological needs of self-determination theory. The participants were assessed before the program, immediately after, and 1 and 3 months after the program. Data were collected from April 23 to September 14, 2018 and analyzed by performing a Chi-square test, Fisher's exact test, independent t-test, and repeated measures ANOVA using SPSS/WIN 23.0.RESULTS: This study showed improvement in the basic psychological needs (F=3.90, p =.010) in the experimental group compared to the control group. Specifically, competence (F=2.93, p =.035), relatedness (F=2.89, p =.045), and self-regulatory ability (F=3.11, p =.028) improved significantly.CONCLUSION: Study findings indicate thatthe smartphone overdependence prevention program based on the Self-determination theory could be an effective intervention for improving basic psychological needs and self-regulation ability. Therefore, this program could be an efficient strategy for smartphone overdependence prevention in university students.
Humans ; Mental Competency ; Personal Autonomy ; Self-Control ; Smartphone

PURPOSE: To examine the effects of a smartphone application-based exercise program on self-efficacy expectations (SEE) and outcome expectations regarding exercise (OEE), physical fitness, activity level, physiological indices, and health-related quality of life in a sample of hemodialysis patients.METHODS: A quasi-experimental control group pre-test post-test design was used. Subjects were recruited from two university hospitals in G city. The subjects were assigned randomly by coin toss: 33 participants to the experimental group and 30 to the control group. A literature review and the self-efficacy theory were used to develop the smartphone program. Experts designed and verified the program to be userfriendly and in consideration of user interaction. Data were collected through a self-report pre-test post-test questionnaire and online medical records.RESULTS: In the experimental group, the levels of physical fitness and physical activity were significantly improved post-test, but the scores on health-related quality of life and the physical indices did not improve. In the experimental group, the SEE and OEE post-test scores were also significantly higher than the pre-test scores, but the control group's scores did not change.CONCLUSION: The smartphone application-based exercise program based on self-efficacy theory significantly improved the level of physical fitness and activity, SEE, and OEE for hemodialysis patients. The use of this application-based exercise program for hemodialysis patients might be an effective nursing intervention tool for improving SEE, OEE, level of physical fitness, and physical activity.
Hospitals, University ; Humans ; Medical Records ; Motor Activity ; Numismatics ; Nursing ; Physical Fitness ; Quality of Life ; Renal Dialysis ; Self Efficacy ; Smartphone

OBJECTIVES: Snacks contribute to the diet quality in youth, which is often poor. Although the US Department of Agriculture (USDA) has guidelines for healthy snacks, this is lost in translation when youth are choosing snacks. To develop a userfriendly app to help identify healthy snacks based on the US Department of Agriculture guidelines and evaluate the app's feasibility, usability, satisfaction, and acceptability. METHODS: The ‘Snackability’ app was developed following the ADDIE (analysis, design, development, implementation, and evaluation) model. The app was pilot tested for 2 weeks among college-age students (18–24 years) using questionnaires and focus groups. Based on the feedback received, the app was improved, and pilot-tested again. RESULTS: The app had a simple score (−1 to 11) and feedback (the higher the score, the healthier the snack is). The 1st pilot test among 12 students showed that the app's feasibility and usability were >50% (p < 0.05). Participants reported that the app was a good way to help individuals select and consume healthy snacks and suggested improving the search process and including average score reports, a ‘consumed history’ tab, gamification, notifications, and the option to add snacks not found. These were incorporated into the 2nd version of the app, which was pilot tested among 8 students. Feasibility, usability, and acceptability of the 2nd version were >50% (p < 0.05). Additional suggestions were to include images for serving size, snack alternatives, and barcode scanning, which were incorporated into the 3rd version. CONCLUSIONS: Snackability app was feasible, usable, satisfactory, and acceptable, and several features were improved as suggested by participants.
Adolescent ; Agriculture ; Diet ; Focus Groups ; Humans ; Serving Size ; Smartphone ; Snacks ; United States Department of Agriculture

OBJECTIVES: Ecological momentary assessment (EMA) methods are known to have validity for capturing momentary changes in variables over time. However, data quality relies on the completion rates, which are influenced by both participants' characteristics and study designs. This study applied an EMA method using a mobile application to assess momentary moods and stress levels in patients with Moyamoya disease to examine variables associated with EMA completion rates. METHODS: Adults with Moyamoya disease were recruited from a tertiary hospital in Seoul. Patients with cognitive impairment were excluded. The EMA survey was loaded as a mobile application onto the participants' personal smartphones. Notifications were sent at semi-random intervals four times a day for seven consecutive days. Daily completion rates were calculated as the percentage of completed responses per day; overall completion rates were calculated as the proportion of completed responses per total of the 28 scheduled measures in the study and assessed through a descriptive analysis, t-test, ANOVA, and regression analysis, with mixed modeling to identify the point at which the daily completion rate significantly decreased. RESULTS: A total of 98 participants responded (mean age, 41.00 ± 10.30 years; 69.4% female; 75.5% married). The overall completion rate was 70.66%, with no gender or age differences found. The daily completion rate decreased significantly after day 5 (p = 0.029). CONCLUSIONS: Obtaining a good completion rate is essential for quality data in EMA methods. Strategic approaches to a study design should be established to encourage participants throughout a study to improve completion rates.
Adult ; Cognition Disorders ; Data Accuracy ; Epidemiologic Factors ; Female ; Guideline Adherence ; Humans ; Methods ; Mobile Applications ; Moyamoya Disease ; Seoul ; Smartphone ; Tertiary Care Centers

OBJECTIVES: The aim of this study was to test the applicability of haptic feedback using a smartwatch to the delivery of cardiac compression (CC) by professional healthcare providers. METHODS: A prospective, randomized, controlled, case-crossover, standardized simulation study of 20 medical professionals was conducted. The participants were randomly assigned into haptic-first and non-haptic-first groups. The primary outcome was an adequate rate of 100–120/min of CC. The secondary outcome was a comparison of CC rate and adequate duration between the good and bad performance groups. RESULTS: The mean interval between CCs and the number of haptic and non-haptic feedback-assisted CCs with an adequate duration were insignificant. In the subgroup analysis, both the good and bad performance groups showed a significant difference in the mean CC interval between the haptic and non-haptic feedback-assisted CC groups—good: haptic feedback-assisted (0.57–0.06) vs. non-haptic feedback-assisted (0.54–0.03), p < 0.001; bad: haptic feedback-assisted (0.57–0.07) vs. non-haptic feedback-assisted (0.58–0.18), p = 0.005—and the adequate chest compression number showed significant differences— good: haptic feedback-assisted (1,597/75.1%) vs. non-haptic feedback-assisted (1,951/92.2%), p < 0.001; bad: haptic feedbackassisted (1,341/63.5%) vs. non-haptic feedback-assisted (523/25.4%), p < 0.001. CONCLUSIONS: A smartwatch cardiopulmonary resuscitation feedback system could not improve rescuers' CC rate. According to our subgroup analysis, participants might be aided by the device to increase the percentage of adequate compressions after one minute.
Cardiopulmonary Resuscitation ; Health Personnel ; Heart Massage ; Humans ; Prospective Studies ; Simulation Training ; Smartphone ; Thorax

OBJECTIVE: This study assessed whether short message service (SMS) reminders would improve follow-up rate among gestational diabetes mellitus (GDM) patients by 12 weeks postpartum.

METHODOLOGY: In this single-center, single-blind randomized controlled trial, we assigned 308 patients with GDM to either of 2 arms, usual care alone versus usual care with SMS reminders. In the usual care group, 154 patients received a 10-minute short lecture on GDM and a 75 g oral glucose tolerance test (OGTT) request prior to discharge. In the SMS group, 154 patients received twice a week SMS reminders at 4 weeks, 8 weeks, and 10 weeks after delivery in addition to usual care. The primary outcome was clinic visit within 6 to 12 weeks postpartum with a 75 g OGTT result.

RESULTS: In our population, the overall follow-up rate was 19.8% (61/308). Follow up rates were 20.1% (31/154) for the usual care group and 19.5% (30/154) for the SMS. The addition of SMS reminders was not associated with an increase in follow-up rate at 12 weeks postpartum (adjusted RR 0.98, 95% CI 0.63-1.52; p=0.932). The use of insulin or metformin for GDM control was associated with increased follow-up (adjusted RR 1.92, 95% CI 1.20-3.07; p=0.006).

CONCLUSION: SMS reminders did not improve postpartum follow-up rate among GDM patients at 12 weeks postpartum.

Human ; Diabetes, Gestational ; Text Messaging