Journal of Medical Internet Research
The leading peer-reviewed journal for digital medicine, and health & healthcare in the Internet age.
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Latest Submissions Open for Peer-Review:
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Mobile phone surveys for collecting population-level estimates in low- and middle-income countries: a review of the literature
Date Submitted: Jan 30, 2017
Open Peer Review Period: Jan 31, 2017 - Mar 28, 2017
Background: National and sub-national level surveys are important for monitoring disease burden, prioritizing resource allocation, and evaluating public health policies. As mobile phone access and own...
Background: National and sub-national level surveys are important for monitoring disease burden, prioritizing resource allocation, and evaluating public health policies. As mobile phone access and ownership become more common globally, mobile phone surveys offer an opportunity to supplement traditional public health household surveys. Objective: To systematically review the current landscape of mobile phone surveys (MPS) to collect population-level estimates in low- and middle- income countries (LMICs). Methods: Primary and grey literature from seven online databases were systematically searched for studies that deployed mobile phone surveys to collect population level estimates. Titles and abstracts were screened on primary inclusion and exclusion criteria by two research assistants. Articles that met primary screening requirements were read in full and screened for secondary eligibility criteria. Articles included in review were grouped into three categories by their survey modality: (1) interactive voice response (IVR), (2) short message service (SMS), and (3) human operator or computer assisted telephone interviews (CATI). Data were abstracted by two research assistants. The conduct and reporting of the review conformed to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Results: A total of 6625 articles were identified through the literature review. Overall, eleven articles were identified that employed 19 MPS (CATI, IVR, or SMS) surveys to collect population-level estimates across a range of topics. Nine articles presented results for ten (10/19; 53%) CATI surveys. Two articles discussed the findings of six (6/19; 32%) IVR surveys. Three SMS surveys were identified from two articles (3/19; 16%). Approximately 63% (12/19) of MPS were delivered to mobile phone numbers collected from previously administered household surveys. The majority of MPS (11/19, 58%) were panel surveys where a cohort of participants, who often were provided a mobile phone upon a face-to-face enrollment, were surveyed multiple times. Conclusions: Of the population-level MPS that were identified, the majority of surveys were conducted using CATI. Due to the limited number of identified IVR and SMS surveys, the relative advantages and disadvantages between the three survey modalities cannot be adequately assessed. The majority of MPS were sent to mobile phone numbers that were collected from a previously administered household survey. There is limited evidence on whether a random digit dial (RDD) approach or a simple random sample of mobile network provided list of numbers can produce a population representative survey.
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HealthyDads.ca: What do Men Want in a Website Designed to Promote Emotional Wellness and Healthy Behaviors in Expectant Fathers?
Date Submitted: Jan 26, 2017
Open Peer Review Period: Jan 26, 2017 - Mar 23, 2017
Background: Up to 18% of men experience depression and/or anxiety during the transition to parenthood. Interventions designed specifically to promote the mental health of expectant fathers are scarce....
Background: Up to 18% of men experience depression and/or anxiety during the transition to parenthood. Interventions designed specifically to promote the mental health of expectant fathers are scarce. Internet delivered interventions may be acceptable and far-reaching in enhancing mental health, parenting knowledge and healthy behaviors in expectant or new fathers. Objective: To guide the development of Healthydads.ca, a website designed to enhance mental health and healthy behaviors in expectant fathers, a needs assessment was conducted to identify father’s perspectives of barriers to seeking help for emotional wellness, informational needs and factors affecting the decision to visit such a website. Methods: 172 men whose partner was expecting or had recently given birth in 3 Canadian provinces (Quebec, Ontario, Alberta), completed an on-line survey inquiring about information needs related to psychosocial aspects of the transition to parenthood, lifestyle behaviors, and parenting, and factors associated with the decision to visit a father focused website. Results: The majority of men (89.1%) reported accessing the internet to obtain information on pregnancy, spending an average of 6.2 hours on-line per month. Seeking information about parenting on the internet was reported by 67.2% of men, with a mean of 4.4 hours per month of on-line searching. Top barriers to seeking help to improve emotional wellness during the perinatal period were: no time to seek help/assistance (74.7%), lack of resources available in the health care system (72.4%), financial costs associated with services (67.8%), and feeling that one should be able to do it alone (64.9%). Information needs that rated highly included: parenting/infant care (52.9-81.6%), supporting (69.5%) and improving relationship with their partner (71.3%), work-family balance (69%), improving sleep (57.5%) and managing stress (56.3%). Perceiving the website as personally relevant (86.7%), credible (81.5%), effective (80.4%), with an easy navigation structure (81%) were identified as important factors related to a first website visit. Providing useful (77%), easy to understand (90.8%) information, free of charge (89.6%) were considered important for deciding to prolong their website visit. Providing the possibility to post questions to a health professional (76.4%), adding new content regularly (68.3%) and personal motivation (63.8%) were factors identified that would encourage a re-visit. Conclusions: Our findings demonstrate that there is substantial interest among expectant fathers for using internet-delivered strategies to prepare for the transition to parenthood and support their mental health. Specific user and website features were identified to optimize use of father focused websites.
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Efficiency of medical supervision on a Multiple Sclerosis web-community: a factorial analysis
Date Submitted: Jan 25, 2017
Open Peer Review Period: Jan 25, 2017 - Feb 2, 2017
Background: The social media represent an important virtual meeting place where users can get in touch with others to share interests and information overcoming limitations of space and time. Conseque...
Background: The social media represent an important virtual meeting place where users can get in touch with others to share interests and information overcoming limitations of space and time. Consequently, social media are a vital link for people with health issues who find in web-communities a valid and comforting source for exchange, debates and for the enrichment of knowledge. This feature is important for people affected by chronic pathologies, like Multiple Sclerosis (MS), who are very well informed about the disease but are vulnerable to hopes of being cured or saved, amplifying therapies that are not always scientifically proven. Objective: We created a MS experts supervised social network (SMsocialnetwork.com) in order to track and share health and social experiences and to improve patients’ knowledge. Methods: Using a 33 item-questionnaire we investigate: 1. Utility Index 2. Proximity Index 3. Sharing Index 4. Interaction Index 5. Solving Uncertainties Index 6. Suggestion’s Attitude Index 7. Explore Index Results: The MS patients/users positively evaluated SMsocialnetwork.com to a) obtain information, approach and solve problems as well as in making decision b) improve feeling of closeness c) catalyze relationship and texting general personal opinions d) receive innovative, effective and practical solutions e) deliver information about innovative therapeutic approaches and treatment options. Conclusions: We have observed that a MS-dedicated social network under the MS experts supervision is perceived from patients/users as a very useful tool to receive information and solve problems in daily life, configuring a new kind of therapeutic alliance between physicians and patients
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Using Twitter to Examine Medicinal Drugs Uptake Statistics and Topics During Flu Seasons
Date Submitted: Jan 25, 2017
Open Peer Review Period: Jan 25, 2017 - Mar 22, 2017
Background: Uptake of medicinal drugs (preventive or treatment) is among the ways used to control disease outbreaks and therefore it is of vital importance to be aware of the statistics of mostly used...
Background: Uptake of medicinal drugs (preventive or treatment) is among the ways used to control disease outbreaks and therefore it is of vital importance to be aware of the statistics of mostly used drugs and trending topics about these drugs from consumers for successful implementation of control measures. Traditional survey methods would have accomplished this study but they are too costly in terms of resources needed and they are subject to social desirability bias for topics discovery. Hence there is a need to use alternative efficient means through Twitter data and machine learning techniques. Objective: Using Twitter data, the study aimed to (1) propose a machine learning classifier that could efficiently identify mostly consumed drugs and (2) extract and analyze trending topics related to these drugs during seasonal flu epidemics. Methods: From tweets collected during the 2012/13 flu season, we first identified tweets with mentions of drugs then we constructed a machine learning classifier using a combination of term frequency inverse document frequency (TFIDF) and parts of speech tagging (POS) of dependency words as features. The classifier was used to extract tweets that evidenced consumption of drugs and then we identified mostly consumed drugs out them. Finally we extracted trending topics from these tweets using latent Dirichtlet allocation (LDA). Results: Our proposed classifier obtained an F1 score of 0.81 which was 2% higher than the benchmark classifier constructed with TFIDF only as the feature. Our classifier extracted 37938 tweets that evidenced consumption of drugs out of 50828 tweets with mentions of drugs. The mostly consumed drugs were influenza virus vaccines which had around 76% share of the total, and others notable drugs were Theraflu, Dayquil, Nyquil, Vitamins, Acetaminophen and Oseltamivir. The content of topics on each of these drugs exhibited common themes for people who have consumed these drugs. Similar drugs but with different names showed similarity in the content of topics discovered. Conclusions: The study utilized Twitter data to identify drugs most consumed instead of using costly traditional survey methods. The proposed classifier exhibited performance improvements in the identification of relevant tweets with evidence of consumption of drugs. Furthermore, topics obtained indicated actual perceptions and behaviors of people who consumed the drugs. These provide public health officials and other stakeholders with valuable information that can help in enhancing strategies for mitigating flu outbreaks severity. The proposed methods are scalable to outbreaks of other health conditions.
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Is there Evidence of Cost and Benefits on Electronic Medical Records, Standards and Interoperability in Hospital Information Systems? An Overview of Systematic Reviews
Date Submitted: Jan 24, 2017
Open Peer Review Period: Jan 25, 2017 - Mar 22, 2017
Background: eHealth interventions may improve the quality of care by providing timely, accessible information about one patient or an entire population. Electronic patient care information forms the n...
Background: eHealth interventions may improve the quality of care by providing timely, accessible information about one patient or an entire population. Electronic patient care information forms the nucleus of computerized health information systems. However, data exchange among systems depends on the adoption of information standards. Additionally, investing in technology systems requires cost-effectiveness studies to ensure the sustainability of processes for stakeholders. Objective: To assess cost effectiveness in the use of electronically available inpatient data systems, information exchange, and standards to support interoperability among systems. Methods: An overview of systematic reviews was conducted, assessing the Medline, Cochrane Library, Lilacs and IEEE Library databases to identify relevant studies published through February 22nd 2016. The search was supplemented by citations from the selected articles. The direct outcome sought was cost effectiveness, and the indirect outcome was the impact on quality of care. Independent reviewers selected studies, and disagreement was resolved by consensus. The quality of the included studies was evaluated using the Measurement Tool to Assess Systematic Reviews (AMSTAR). Results: The primary search identified 286 papers, and two were manually included. Two hundred eleven were systematic reviews. From the 20 studies that were selected after screening the title and abstract, 14 were deemed ineligible, and six accepted to the reviewing process. The interventions did not show a direct, measurable effect on cost effectiveness. Despite the limited number of studies, the heterogeneity of electronic systems reported, and types of intervention on hospital routines, it was possible to identify some preliminary, indirect benefits on quality of care. Hospital information systems, along with information sharing, had the potential to improve clinical practice by reducing staff errors or incidents, improving automated harm detection, monitoring infection more effectively, and enhancing the continuity of care during physician handoffs. Conclusions: This review identified some indirect benefits on the quality of care but did not provide evidence that the implementation of eHealth interventions had a measurable impact on cost effectiveness or patient outcomes in hospital settings. However, further evidence is needed to infer the impact of interoperability on costs or benefits of health care; that requires further research.
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Mental health mobile apps for children and young people: A systematic review and synthesis
Date Submitted: Jan 23, 2017
Open Peer Review Period: Jan 23, 2017 - Mar 20, 2017
Background: There are an increasing number of mobile applications (apps) available for children and young people (CYP) with mental health problems and an increasing interest in assimilating mHealth in...
Background: There are an increasing number of mobile applications (apps) available for children and young people (CYP) with mental health problems and an increasing interest in assimilating mHealth into mental health services. Despite the growing number of apps available, the evidence base for their efficacy is unclear. Objective: This review aimed to systematically appraise the available research evidence on the efficacy and acceptability of mobile apps for mental health in CYP under the age of 18. Methods: APA PsychNet, ACM Digital Library, Cochrane Library, Community Care Inform – Children, Embase, Google Scholar, Pubmed, Scopus, Social Policy and Practice, Web of Science, Journal of Medical Internet Research, Cyberpsychology, Behavior and Social Networking and OpenGrey were systematically searched for relevant publications between January 2008 and July 2016. Abstracts were included if they described mental health apps (targeting depression, bipolar disorder, anxiety disorders, self – harm, suicide prevention, conduct disorder, eating disorders and body image issues, schizophrenia, psychosis and insomnia) for mobile devices and for use by children and young people under the age of 18 years. Results: Thirty-two publications met the inclusion criteria. These described 19 apps, 3 of which were available to download. Two small randomised controlled trials and one case study failed to demonstrate a significant effect of three apps on intended mental health outcomes. Reviews which analysed the content of seven apps for CYP that are available to download established that none have undergone any research evaluation. Feasibility outcomes suggest acceptability of apps is good and app usage is moderate. Conclusions: Overall there is currently insufficient research evidence to support the effectiveness of apps for children and young people with mental health problems. Given the number and pace at which mHealth apps are being released on app stores, methodologically robust research studies evaluating their safety, efficacy and effectiveness is promptly needed.
