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Vol 14, No 4 (2012) - Jul-Aug


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Web-based and Mobile Health Interventions

Internet-Based Brief Personalized Feedback Intervention in a Non-Treatment-Seeking Population of Adult Heavy Drinkers: A Randomized Controlled Trial

Anders Blædel Gottlieb Hansen, Ulrik Becker, Anette Søgaard Nielsen, Morten Grønbæk, Janne Schurmann Tolstrup, Lau Caspar Thygesen

J Med Internet Res 2012 (Jul 30); 14(4):e98

HTML PDF XML Abstract

Background: Internet-based interventions for heavy drinkers show promising results, but existing research is characterized by few studies in nonstudent adult populations and few comparisons with appropriate control groups. Objective: To test whether a fully automated Internet-based brief personalized feedback intervention and a fully automated Internet-based personalized brief advice intervention in a non-treatment-seeking population of heavy drinkers would result in a reduced alcohol intake....

Comparison of Two Internet-Based Interventions for Problem Drinkers: Randomized Controlled Trial

John Alastair Cunningham

J Med Internet Res 2012 (Aug 01); 14(4):e107

HTML PDF XML Abstract

Background: Alcohol problems are a serious public health concern, and few problem drinkers ever seek treatment. The Internet is one means of promoting access to care, but more research is needed to test the best types of interventions to employ. Evaluation of Internet-based interventions that contain a variety of research-validated cognitive-behavioral tools, which have been shown to be helpful to those with more severe alcohol concerns, should be a priority. Objective: To evaluate whether...

Public Health Interventions: Reaching Latino Adolescents via Short Message Service and Social Media

Amita N. Vyas, Megan Landry, Marisa Schnider, Angela M. Rojas, Susan F. Wood

J Med Internet Res 2012 (Jul 12); 14(4):e99

HTML PDF XML Abstract

Background: Adolescents are substantial users of short message service (SMS) and social media. The public health community now has more opportunities to reach this population with positive youth development and health messages through these media. Latinos are a growing and youthful population with significant health risks and needs. This population may benefit from SMS and social media health interventions. Objective: To examine (1) SMS and social media utilization and behavior among Latino...

The Effects of Combining Web-Based eHealth With Telephone Nurse Case Management for Pediatric Asthma Control: A Randomized Controlled Trial

David Gustafson, Meg Wise, Abhik Bhattacharya, Alice Pulvermacher, Kathleen Shanovich, Brenda Phillips, Erik Lehman, Vernon Chinchilli, Robert Hawkins, Jee-Seon Kim

J Med Internet Res 2012 (Jul 26); 14(4):e101

HTML PDF XML Abstract

Background: Asthma is the most common pediatric illness in the United States, burdening low-income and minority families disproportionately and contributing to high health care costs. Clinic-based asthma education and telephone case management have had mixed results on asthma control, as have eHealth programs and online games. Objectives: To test the effects of (1) CHESS+CM, a system for parents and children ages 4–12 years with poorly controlled asthma, on asthma control and medication...

Effects of Functional Interactivity on Patients’ Knowledge, Empowerment, and Health Outcomes: An Experimental Model-Driven Evaluation of a Web-Based Intervention

Luca Camerini, Peter Johannes Schulz

J Med Internet Res 2012 (Jul 18); 14(4):e105

HTML PDF XML Abstract

Background: The effectiveness of eHealth interventions in terms of reach and outcomes is now well documented. However, there is a need to understand not only whether eHealth interventions work, but also what kind of functions and mechanisms enhance their effectiveness. The present investigation contributes to tackling these challenges by investigating the role played by functional interactivity on patients’ knowledge, empowerment, and health outcomes. Objectives: To test whether health...

Use of Email and Telephone Prompts to Increase Self-Monitoring in a Web-Based Intervention: Randomized Controlled Trial

Mary L Greaney, Kim Sprunck-Harrild, Gary G Bennett, Elaine Puleo, Jess Haines, K Vish Viswanath, Karen M Emmons

J Med Internet Res 2012 (Jul 27); 14(4):e96

HTML PDF XML Abstract

Background: Self-monitoring is a key behavior change mechanism associated with sustained health behavior change. Although Web-based interventions can offer user-friendly approaches for self-monitoring, engagement with these tools is suboptimal. Increased use could encourage, promote, and sustain behavior change. Objective: To determine whether email prompts or email plus telephone prompts increase self-monitoring of behaviors on a website created for a multiple cancer risk reduction program....

Preventing Smoking Relapse via Web-Based Computer-Tailored Feedback: A Randomized Controlled Trial

Iman Elfeddali, Catherine Bolman, Math J.J.M. Candel, Reinout W. Wiers, Hein de Vries

J Med Internet Res 2012 (Aug 20); 14(4):e109

HTML PDF XML Abstract

Background: Web-based computer-tailored approaches have the potential to be successful in supporting smoking cessation. However, the potential effects of such approaches for relapse prevention and the value of incorporating action planning strategies to effectively prevent smoking relapse have not been fully explored. The Stay Quit for You (SQ4U) study compared two Web-based computer-tailored smoking relapse prevention programs with different types of planning strategies versus a control...

Mobile Health (mhealth)

Design Considerations in Developing a Text Messaging Program Aimed at Smoking Cessation

Michele L Ybarra, Jodi Summers Holtrop, A Tülay Bağci Bosi, Salih Emri

J Med Internet Res 2012 (Jul 24); 14(4):e103

HTML PDF XML Abstract

Background: Cell phone text messaging is gaining increasing recognition as an important tool that can be harnessed for prevention and intervention programs across a wide variety of health research applications. Despite the growing body of literature reporting positive outcomes, very little is available about the design decisions that scaffold the development of text messaging-based health interventions. What seems to be missing is documentation of the thought process of investigators in the...

Improving Diabetes Care for Young People With Type 1 Diabetes Through Visual Learning on Mobile Phones: Mixed-Methods Study

Dag Helge Frøisland, Eirik Årsand, Finn Skårderud

J Med Internet Res 2012 (Aug 06); 14(4):e111

HTML PDF XML Abstract

Background: Only 17% of Norwegian children and adolescents with diabetes achieve international treatment goals measured by glycated hemoglobin (HbA1c). Classic patient–physician consultations seem to be poorly adapted to young children. New strategies that are better attuned to young people to improve support of adolescents’ self-management of diabetes need to be tested and evaluated. Objective: (1) To explore how applications for mobile phones can be used in follow-up of...

Making Sense of Mobile Health Data: An Open Architecture to Improve Individual- and Population-Level Health

Connie Chen, David Haddad, Joshua Selsky, Julia E Hoffman, Richard L Kravitz, Deborah E Estrin, Ida Sim

J Med Internet Res 2012 (Aug 09); 14(4):e112

HTML PDF XML Abstract

Mobile phones and devices, with their constant presence, data connectivity, and multiple intrinsic sensors, can support around-the-clock chronic disease prevention and management that is integrated with daily life. These mobile health (mHealth) devices can produce tremendous amounts of location-rich, real-time, high-frequency data. Unfortunately, these data are often full of bias, noise, variability, and gaps. Robust tools and techniques have not yet been developed to make mHealth data more...

Internet-based Survey & Research Methodology

Online Advertising to Reach and Recruit Latino Smokers to an Internet Cessation Program: Impact and Costs

Amanda L. Graham, Ye Fang, Jose L. Moreno, Shawn L. Streiff, Jorge Villegas, Ricardo F. Muñoz, Kenneth P. Tercyak, Jeanne S. Mandelblatt, Donna M. Vallone

J Med Internet Res 2012 (Aug 27); 14(4):e116

HTML PDF XML Abstract

Background: Tobacco cessation among Latinos is a public health priority in the United States, particularly given the relatively high growth of this population segment. Although a substantial percentage of American Latinos use the Internet, they have not engaged in Web-based cessation programs as readily as other racial/ethnic subgroups. A lack of culturally specific advertising efforts may partly explain this disparity. Objective: Phase I of this study focused on the development of four...

Consumer & Patient Education and Shared-Decision Making

Animated Graphics for Comparing Two Risks: A Cautionary Tale

Brian J Zikmund-Fisher, Holly O Witteman, Andrea Fuhrel-Forbis, Nicole L Exe, Valerie C Kahn, Mark Dickson

J Med Internet Res 2012 (Jul 25); 14(4):e106

HTML PDF XML Abstract

Background: The increasing use of computer-administered risk communications affords the potential to replace static risk graphics with animations that use motion cues to reinforce key risk messages. Research on the use of animated graphics, however, has yielded mixed findings, and little research exists to identify the specific animations that might improve risk knowledge and patients’ decision making. Objective: To test whether viewing animated forms of standard pictograph (icon array)...

Personal Health Records and Patient Portals

Are Personal Health Records Safe? A Review of Free Web-Accessible Personal Health Record Privacy Policies

Inmaculada Carrión Señor, José Luis Fernández-Alemán, Ambrosio Toval

J Med Internet Res 2012 (Aug 23); 14(4):e114

HTML PDF XML Abstract

Background: Several obstacles prevent the adoption and use of personal health record (PHR) systems, including users’ concerns regarding the privacy and security of their personal health information. Objective: To analyze the privacy and security characteristics of PHR privacy policies. It is hoped that identification of the strengths and weaknesses of the PHR systems will be useful for PHR users, health care professionals, decision makers, and designers. Methods: We conducted a...

e-Mental Health and Cyberpsychology

The Therapeutic Relationship in E-Therapy for Mental Health: A Systematic Review

Madalina Sucala, Julie B Schnur, Michael J Constantino, Sarah J Miller, Emily H Brackman, Guy H Montgomery

J Med Internet Res 2012 (Aug 02); 14(4):e110

HTML PDF XML Abstract

Background: E-therapy is defined as a licensed mental health care professional providing mental health services via e-mail, video conferencing, virtual reality technology, chat technology, or any combination of these. The use of e-therapy has been rapidly expanding in the last two decades, with growing evidence suggesting that the provision of mental health services over the Internet is both clinically efficacious and cost effective. Yet there are still unanswered concerns about e-therapy,...

Munchausen by Internet: Current Research and Future Directions

Andy Pulman, Jacqui Taylor

J Med Internet Res 2012 (Aug 22); 14(4):e115

HTML PDF XML Abstract

Background: The Internet has revolutionized the health world, enabling self-diagnosis and online support to take place irrespective of time or location. Alongside the positive aspects for an individual’s health from making use of the Internet, debate has intensified on how the increasing use of Web technology might have a negative impact on patients, caregivers, and practitioners. One such negative health-related behavior is Munchausen by Internet. Objective: Munchausen by Internet...

Demographics of Users, Social & Digital Divide

Socioeconomic and Geographic Disparities in Health Information Seeking and Internet Use in Puerto Rico

Lila J Finney Rutten, Bradford W Hesse, Richard P Moser, Ana Patricia Ortiz Martinez, Julie Kornfeld, Robin C Vanderpool, Margaret Byrne, Guillermo Tortolero Luna

J Med Internet Res 2012 (Jul 19); 14(4):e104

HTML PDF XML Abstract

Background: Geographically isolated Hispanic populations, such as those living in Puerto Rico, may face unique barriers to health information access. However, little is known about health information access and health information-seeking behaviors of this population. Objective: To examine differences in health and cancer information seeking among survey respondents who ever used the Internet and those who did not, and to explore sociodemographic and geographic trends. Methods: Data for our...

Computer Skills and Internet Use in Adults Aged 50-74 Years: Influence of Hearing Difficulties

Helen Henshaw, Daniel P A Clark, Sujin Kang, Melanie A Ferguson

J Med Internet Res 2012 (Aug 24); 14(4):e113

HTML PDF XML Abstract

Background: The use of personal computers (PCs) and the Internet to provide health care information and interventions has increased substantially over the past decade. Yet the effectiveness of such an approach is highly dependent upon whether the target population has both access and the skill set required to use this technology. This is particularly relevant in the delivery of hearing health care because most people with hearing loss are over 50 years (average age for initial hearing aid...

Ethics, Privacy, and Legal Issues

P2P Watch: Personal Health Information Detection in Peer-to-Peer File-Sharing Networks

Marina Sokolova, Khaled El Emam, Luk Arbuckle, Emilio Neri, Sean Rose, Elizabeth Jonker

J Med Internet Res 2012 (Jul 09); 14(4):e95

HTML PDF XML Abstract

Background: Users of peer-to-peer (P2P) file-sharing networks risk the inadvertent disclosure of personal health information (PHI). In addition to potentially causing harm to the affected individuals, this can heighten the risk of data breaches for health information custodians. Automated PHI detection tools that crawl the P2P networks can identify PHI and alert custodians. While there has been previous work on the detection of personal information in electronic health records, there has been...

Quality/Credibility of eHealth Information and Trust Issues

Impact of the Presence of Medical Equipment in Images on Viewers’ Perceptions of the Trustworthiness of an Individual On-Screen

Moyez Jiwa, Stephan Millett, Xingqiong Meng, Vivien M Hewitt

J Med Internet Res 2012 (Jul 10); 14(4):e100

HTML PDF XML Abstract

Background: It is now common practice for doctors to consult patients by means other than face-to-face, often appearing before the patient on a computer screen. Also, many websites are using depictions of health professionals to increase the credibility of their services. Being trustworthy is an essential attribute for successful ehealth services. Little is known about which depicted accessories make a health professional appear more trustworthy. Objective: To estimate the odds of an...

Research Instruments, Questionnaires, and Tools

Adoption, Acceptability, and Accuracy of an Online Clinical Trial Matching Website for Breast Cancer

Ellyn Cohen, Jeff Belkora, Joanne Tyler, Joan Schreiner, Mary Jo Deering, Lakshmi Grama, Brenda Duggan, Julie Illi, Julia Pederson, Aprajita Anand, Alexandra Teng, Erin McCreary, Dan Moore, Debu Tripathy, Michael Hogarth, Morton Lieberman, John Park, Laura Esserman

J Med Internet Res 2012 (Jul 11); 14(4):e97

HTML PDF XML Abstract

Background: Less than 5% of breast cancer patients participate in clinical trials. To increase patients’ awareness and access to trials, we created BreastCancerTrials.org, a clinical trial matching website. BreastCancerTrials.org matched patients to trials based on their self-reported breast cancer history. It also provided a messaging platform through which patients could self-refer themselves to participating research sites. Objective: To assess adoption by research sites,...

New Methods

Speech Perception Benefits of Internet Versus Conventional Telephony for Hearing-Impaired Individuals

Georgios Mantokoudis, Patrick Dubach, Flurin Pfiffner, Martin Kompis, Marco Caversaccio, Pascal Senn

J Med Internet Res 2012 (Jul 16); 14(4):e102

HTML PDF XML Abstract

Background: Telephone communication is a challenge for many hearing-impaired individuals. One important technical reason for this difficulty is the restricted frequency range (0.3–3.4 kHz) of conventional landline telephones. Internet telephony (voice over Internet protocol [VoIP]) is transmitted with a larger frequency range (0.1–8 kHz) and therefore includes more frequencies relevant to speech perception. According to a recently published, laboratory-based study, the theoretical...

Corrigenda and Addenda

Correction: Development and Validation of Filters for the Retrieval of Studies of Clinical Examination From Medline

Robert Badgett, Nader Shaikh, Mini Pi, Nancy L Wilczynski, K. Ann McKibbon, Andrea M. Ketchum, R. Brian Haynes

J Med Internet Res 2012 (Aug 03); 14(4):e108

HTML PDF XML Abstract

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From interactive Journal of Medical Research (ISSN 1929-073X)

The Effectiveness of an Interactive 3-Dimensional Computer Graphics Model for Medical Education

Bayanmunkh Battulga, Takeshi Konishi, Yoko Tamura, Hiroki Moriguchi

Interact J Med Res 2012 (Jul 09); 1(2):e2

HTML PDF XML Abstract

Background: Medical students often have difficulty achieving a conceptual understanding of 3-dimensional (3D) anatomy, such as bone alignment, muscles, and complex movements, from 2-dimensional (2D) images. To this end, animated and interactive 3-dimensional computer graphics (3DCG) can provide better visual information to users. In medical fields, research on the advantages of 3DCG in medical education is relatively new. Objective: To determine the educational effectiveness of interactive...

Perceived Impact of Electronic Medical Records in Physician Office Practices: A Review of Survey-Based Research

Jesdeep Bassi, Francis Lau, Mary Lesperance

Interact J Med Res 2012 (Jul 28); 1(2):e3

HTML PDF XML Abstract

Background: Physician office practices are increasingly adopting electronic medical records (EMRs). Therefore, the impact of such systems needs to be evaluated to ensure they are helping practices to realize expected benefits. In addition to experimental and observational studies examining objective impacts, the user’s subjective view needs to be understood, since ultimate acceptance and use of the system depends on them. Surveys are commonly used to elicit these views. Objective: To...

From JMIR Research Protocols (ISSN 1929-0748)

A Collaborative Quality Improvement Model and Electronic Community of Practice to Support Sepsis Management in Emergency Departments: Investigating Care Harmonization for Provincial Knowledge Translation

Kendall Ho, Julian Marsden, Sandra Jarvis-Selinger, Helen Novak Lauscher, Noreen Kamal, Rob Stenstrom, David Sweet, Ran D Goldman, Grant Innes

JMIR Res Protoc 2012 (Jul 12); 1(2):e6

HTML PDF XML Abstract

Emergency medicine departments within several organizations are now advocating the adoption of early intervention guidelines for patients with the signs and symptoms of sepsis. This proposed research will lead to a comprehensive understanding of how diverse emergency department (ED) sites across British Columbia (BC), Canada, engage in a quality improvement collaborative to lead to improvements in time-based process measures and clinical outcomes for septic patients in EDs. To address the...

Lifetime Occupational Physical Activity and Musculoskeletal Aging in Middle-Aged Men and Women in Denmark: Retrospective Cohort Study Protocol and Methods

Anne Møller, Ole Steen Mortensen, Susanne Reventlow, Peder Georg Skov, Johan Hviid Andersen, Tine Steen Rubak, Åse Marie Hansen, Lars L Andersen, Rikke Lund, Merete Osler, Ulla Christensen, Kirsten Avlund

JMIR Res Protoc 2012 (Jul 27); 1(2):e7

HTML PDF XML Abstract

Background: Physical function is essential for performing most aspects of daily life and musculoskeletal aging leads to a decline in physical function. The onset and rate of this process vary and are influenced by environmental, genetic, and hormonal factors. Although everyone eventually experiences musculoskeletal aging, it is beneficial to study the factors that influence the aging process in order to prevent disability. The role of occupational physical activity in the musculoskeletal...

Mobile.net: Mobile Telephone Text Messages to Encourage Adherence to Medication and to Follow up With People With Psychosis: Methods and Protocol for a Multicenter Randomized Controlled Two-Armed Trial

Maritta Välimäki, Heli Hätönen, Clive E Adams

JMIR Res Protoc 2012 (Aug 02); 1(2):e8

HTML PDF XML Abstract

Background: Schizophrenia is a high-cost, chronic, serious mental illness. There is a clear need to improve treatments and expand access to care for persons with schizophrenia, but simple, tailored interventions are missing. Objective: To evaluate the impact of tailored mobile telephone text messages to encourage adherence to medication and to follow up with people with psychosis at 12 months. Methods: Mobile.Net is a pragmatic randomized trial with inpatient psychiatric wards allocated to...

Development of Smartphone Applications for Nutrition and Physical Activity Behavior Change

Lana Hebden, Amelia Cook, Hidde P. van der Ploeg, Margaret Allman-Farinelli

JMIR Res Protoc 2012 (Aug 22); 1(2):e9

HTML PDF XML Abstract

Background: Young adults (aged 18 to 35) are a population group at high risk for weight gain, yet we know little about how to intervene in this group. Easy access to treatment and support with self-monitoring of their behaviors may be important. Smartphones are gaining in popularity with this population group and software applications (“apps”) used on these mobile devices are a novel technology that can be used to deliver brief health behavior change interventions directly to...

From Medicine 2.0 (ISSN 1923-2195)

Physicians' Motives for Professional Internet Use and Differences in Attitudes Toward the Internet-Informed Patient, Physician–Patient Communication, and Prescribing Behavior

Martina Moick, Ralf Terlutter

Med 2.0 2012 (Jul 06); 1(2):e2

HTML PDF XML Abstract

Background: Physicians have differing motives for using the Internet and Internet-related services in their professional work. These motives may affect their evaluation of patients who bring with them health-related information from the Internet. Differing motives may also affect physician–patient communication and subsequent prescribing behavior. Objectives: To segment physicians into types based on their motives for using the Internet in connection with professional activities and to...

Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress

Elizabeth Murray

Med 2.0 2012 (Aug 14); 1(2):e3

HTML PDF XML Abstract

The potential advantages of using the Internet to deliver self-care and behavior-change programs are well recognized. An aging population combined with the increasing prevalence of long-term conditions and more effective medical interventions place financial strain on all health care systems. Web-based interventions have the potential to combine the tailored approach of face-to-face interventions with the scalability of public health interventions that have low marginal costs per additional...