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Purpose Methods Results Conclusion To evaluate the feasibility and acceptability of self‐tonometry by glaucoma patients using iCare® Home2 (ICH2) and a smartphone application, without healthcare personnel supervision.After downloading a smartphone application, participants learned to handle the ICH2 via an instruction film, measured their intraocular pressure (IOP) and transferred the data to the caregiver via the application. Participants' measurements were compared to healthcare personnel measurements using Goldmann applanation tonometry (GAT). Participants answered questionnaires about their experience of self‐tonometry.Twenty‐eight participants were included in the study and three of them dropped off. There was no statistically significant difference between the last measurements obtained with ICH2 by the participants and the GAT measurements for the right and the left eye, p = 0.781 and p = 0.888 respectively. The inter‐user agreement was good to excellent between the last measurements obtained with ICH2 by the participants and the GAT measurements for the right and the left eye (ICC 0.907 and 0.830 respectively). The overall impression of the participants was very positive, with 92% happy (a lot or completely) with the instruction film and 88% happy (a lot or completely) with the smartphone application. Thirty‐six percent would have preferred to have an instructor by their side.Our study showed the feasibility and acceptability of self‐tonometry with iCare® Home2 and a smartphone application without the supervision of a healthcare provider in a group of motivated glaucoma patients. [ABSTRACT FROM AUTHOR]

Background and aims: iCanQuit is a smartphone application (app) proven efficacious for smoking cessation in a Phase III randomized controlled trial (RCT). This study aimed to measure whether medications approved by the US Food and Drug Administration (FDA) for smoking cessation would further enhance the efficacy of iCanQuit, relative to its parent trial comparator—the National Cancer Institute's (NCI's) QuitGuide app. Design: Secondary analysis of the entire parent trial sample of a two‐group (iCanQuit and QuitGuide), stratified, doubled‐blind RCT. Setting: United States. Participants: Participants who reported using an FDA‐approved cessation medication on their own (n = 619) and those who reported no use of cessation medications (n = 1469). Interventions: Participants were randomized to receive iCanQuit app or NCI's QuitGuide app. Measurements Use of FDA‐approved medications was measured at 3 months post‐randomization. Smoking cessation outcomes were measured at 3, 6 and 12 months. The primary outcome was 12‐month self‐reported 30‐day point prevalence abstinence (PPA). Findings The data retention rate at the 12‐month follow‐up was 94.0%. Participants were aged 38.5 years, 71.0% female, 36.6% minority race/ethnicity, 40.6% high school or less education, residing in all 50 US States and smoking 19.2 cigarettes/day. The 29.6% of all participants who used medications were more likely to choose nicotine replacement therapy (NRT; 78.8%) than other cessation medications (i.e. varenicline or bupropion; 18.3 and 10.5%, respectively) and use did not differ by app treatment assignment (all P > 0.05). There was a significant (P = 0.049) interaction between medication use and app treatment assignment on PPA. Specifically, 12‐month quit rates were 34% for iCanQuit versus 20% for QuitGuide [odds ratio (OR) = 2.36, 95% confidence interval (CI) = 1.59, 3.49] among participants reporting any medication use, whereas among participants reporting no medication use, quit rates were 28% for iCanQuit versus 22% for QuitGuide (OR = 1.41, 95% CI = 1.09, 1.82). Results were stronger for those using only NRT: 40% quit rates for iCanQuit versus 18% quit rates for QuitGuide (OR = 3.57, 95% CI = 2.20, 5.79). Conclusions: The iCanQuit smartphone app for smoking cessation was more efficacious than the QuitGuide smartphone app, regardless of whether participants used medications to aid cessation. Smoking cessation medications, especially nicotine replacement therapy, might enhance the efficacy of the iCanQuit app. [ABSTRACT FROM AUTHOR]

Background and Aim: Chronic liver disease and cirrhosis is a significant cause of healthcare utilization and patient morbidity and mortality worldwide. Smartphone applications have high uptake in most communities and therefore have great potential to provide remote support solutions to this patient population. The aim of this scoping review was therefore to provide a comprehensive overview using narrative synthesis on the use of smartphone‐application‐based digital interventions in cirrhotic populations. Materials and Methods: PRISMA guidelines were followed, with two independent researchers identifying 10 relevant studies. Patients studied were predominantly those with decompensated cirrhosis, and hepatic encephalopathy was the most common complication studied. Results: Smartphones were the most common platform used, but training periods, prior to commencement of the study, were rarely offered. Patient engagement rates with the technology were reported only in three studies, but all reported high (>50%) rates of engagement. Only one study examined the clinical effects of their digital intervention, with a 38% reduction in readmission rate reported. Conclusion: Overall, the use of smartphone apps in cirrhosis is in an early phase of development and evaluation but preliminary studies suggest significant potential as an adjunct to routine medical care. Further high‐quality studies of well‐designed digital interventions are needed to advance this promising early experience. [ABSTRACT FROM AUTHOR]

Background and aims: Black adults who smoke are less likely to seek treatment and to succeed in quitting compared with other racial groups. The lack of efficacious and engaging trials for smoking cessation further contributes to this disparity. This study explored whether an acceptance and commitment therapy (ACT)-based smartphone application (iCanQuit) was more efficacious for smoking cessation than a United States Clinical Practice Guidelines (USCPG)-based smartphone application (QuitGuide) among Black adults. Design: Secondary analysis of a two-arm randomized trial with 12-month follow-up. Setting: United States (US). Participants: A total of 554 Black adults who smoke daily were recruited from 34 US states and enrolled between May 2017 and September 2018. Interventions: Participants were randomized to receive iCanQuit (n = 274) or QuitGuide (n = 280) for 12 months. Measurements: Smoking cessation outcomes were measured at 3, 6, and 12 months. The primary outcome was self-reported complete-case 30-day point prevalence abstinence (PPA) at 12 months. Secondary outcomes were 7-day PPA, missing-as-smoking imputation, multiple imputation, prolonged abstinence, and cessation of all tobacco products at 12 months. Study retention, treatment engagement, and change in ACT-based processes were also compared between arms. Findings: Study retention was 89% at 12 months and did not differ by arm (P > 0.05). The complete-case 30-day PPA was 28% for iCanQuit versus 20% for QuitGuide at 12 months (odds ratio [OR] = 1.60; 95% confidence interval [CI] = 1.03, 2.46). Similar associations were observed for the missing-as-smoking imputation, although non-significant (25% iCanQuit vs 18% QuitGuide; OR = 1.50; 95% CI = 0.98, 2.30). iCanQuit vs QuitGuide participants were significantly more engaged with iCanQuit application as measured by the number of logins from baseline to 6 months (incidence rate ratio = 3.26; 95% CI = 2.58, 4.13). Increased acceptance of cues to smoke mediated the effect of treatment on cessation (indirect effect: OR = 0.20; 95% CI = 0.05, 0.29). Conclusions: Among Black adults, an acceptance and commitment therapy-based smartphone application appeared to be more efficacious and engaging for smoking cessation than the United States Clinical Practice Guidelines-based QuitGuide application. [ABSTRACT FROM AUTHOR]

Identifying sustainable land management practices within smallholder agriculture is a challenge. This is partly driven by the challenge of documenting farmers' perspectives and practices in an integrated manner with site‐specific scientific soil assessment. Smartphone applications such as LandPKS provide new approaches to quantify site‐specific soil degradation and fertility but are untested with African farm management. We surveyed 578 households in rain‐fed maize (Zea mays) production areas of Tanzania using a stratified sampling frame to encompass a wide range of soils and agroecologies. A socio‐economic survey and simultaneous sampling in focal plots documented farmer characteristics, perspectives, and management practices, along with soil properties and crop yields. For a subsample of 58 households, we additionally assessed site‐specific field status with the LandPKS application. Farmer perceptions of change in soil fertility status were consistent with soil properties, for example, a field perceived to be declining in fertility was also likely to have low SOC (1.8% relative to 2.7% for increasing fertility). LandPKS provided additional novel insights into soil limitations such as identifying poor water infiltration areas consistently associated with farmer use of erosion control practices (water infiltration of 4 mm hr−1 vs 20 all other plots). This charts a way forward to address soil fertility and land degradation challenges through the use of smartphone applications to capture site‐specific conditions and farmer concerns as the basis for land management recommendations that are highly relevant and address local conditions. [ABSTRACT FROM AUTHOR]

The importance of diet during pregnancy is critically important for the short‐ and long‐term health of both mother and child. The number of apps targeting pregnant women is rapidly increasing, yet the nutritional content of these tools remains largely unexplored. This review aimed to evaluate the coverage and content of nutrition information in smartphone apps available to U.K. pregnant women. Keyword searches were conducted in iTunes and Google Play stores in November 2018. Candidate apps were included if they targeted pregnant women, provided pregnancy‐specific nutritional information, had a user rating of at least 4+ based on at least 20 ratings, and were available in English. Nutritional content was assessed for accuracy against U.K. recommendations. Behaviour change techniques (BCTs) were also evaluated. Twenty‐nine apps were included, seven of which originated in the United Kingdom. There was a large variability in the quality of smartphone app nutritional information. The accuracy of nutrition information varied, and several apps conveyed inappropriate information for pregnancy. On average, 10 BCTs were identified per app (range 2–15). Overall, smartphone apps do not consistently provide accurate and useful nutritional information to pregnant women. This study highlights the need for the integration of evidence‐based nutritional information during app development and for increased regulatory oversight. App developers should also make it clear that nutritional content is intended for a specific geographical region or population or modify for the intended audience. These are important considerations for the design of future apps, which are increasingly used to complement existing maternity services. [ABSTRACT FROM AUTHOR]

Background: Supportive care is a critical component of the treatment of cancer patients that is underutilized; patient lack of information about these services is an important barrier. Mobile technologies may be useful tools for delivering information, but cancer patient use of and interest in using them to learn about supportive care services have not been described. This study evaluates factors associated with cancer patient use of mobile technologies and interest in smartphone applications for information delivery about supportive care. Methods: We conducted a cross‐sectional survey among cancer patients from one urban academic hospital and 11 community hospitals. Patients self‐reported use of mobile technologies and interest in smartphone applications. Multivariate logistic analysis was used to identify determinants of mobile technology use and smartphone interest. Results: Among 631 participants, 466 (74%) reported regular use of mobile devices and 242 (39%) expressed an interest in supportive care information via smartphone applications. Patients under 45 were more likely to use a mobile device (Adjusted Odds Ratio [AOR] 6.8, 2.8‐16.9 95% CI, P < 0.001) and were interested in smartphone applications for delivery of information (AOR 3.2, 1.8‐5.9 95% CI, P < 0.001). Non‐white patients had similar use of mobile technology compared to whites but reported greater interest in smartphone application‐based information (AOR 3.4, 2.1‐5.5 95% CI, P < 0.001). Conclusion: Many patients expressed interest in smartphone application‐based information about supportive care services, especially those who are younger and non‐white. Future studies should investigate the characteristics of patients and smartphones applications that will optimize information delivery through a mobile technology platform. This study assesses the demographic and treatment‐related characteristics associated with mobile technology use and smartphone application interest in a mixed patient population from academic and community settings. It was found that age and race impact mobile technology use and interest in smartphone applications with younger and non‐white populations expressing an interest in smartphones at three times the reference group. [ABSTRACT FROM AUTHOR]

To facilitate easily accessible screening for trauma-related symptoms, a web-based application called Smart Assessment on your Mobile (SAM) was developed. In this study, we examined whether SAM was able to accurately identify posttraumatic stress disorder (PTSD) and depression in adults. Eighty-nine referred police officers completed SAM, containing the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 (PCL-5) and the Depression Anxiety and Stress Scale (DASS-21), on their own device prior to a diagnostic interview where the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) and Structured Clinical Interview for DSM-IV (SCID-I/P) were administered. Results showed a substantial agreement between SAM and the diagnostic interview in the assessment of PTSD and depression. An optimal trade-off between sensitivity (89%) and specificity (68%) levels was found at a cut-off score of 31 on the PTSD Checklist for DSM-5 (area under the curve = 0.845, 95% CI [0.765, 0.925], diagnostic odds ratio = 15.97). This is one of the first studies to support the validity and reliability of a mobile screener following trauma. SAM may facilitate screening for trauma-related symptoms on a large scale and could be a first step in a stepped-care model for trauma survivors to help identify individuals who need further diagnostics and care. [ABSTRACT FROM AUTHOR]

Background Smartphone health applications (apps) and other mobile health (mHealth) technologies may assist dietitians in improving the efficiency of patient care. The present study investigated the use of health apps and text messaging in dietetic practice and formulated intervention recommendations for supporting app uptake by dietitians based on the behavioural ' COM-B' system, where interactions between capability, opportunity and motivation influence behaviour. Methods A 52-item online survey tool, taking 20 min to complete, was developed and piloted, with questions exploring the use of health apps and text messaging in dietetic practice, types of apps dietitians recommended and that patients used, and barriers and enablers to app use in dietetic practice. The Australian, New Zealand and British dietetic associations distributed the survey to their members. Results A 5% response rate was achieved internationally, with 570 completed responses included for further analysis. Health apps, namely nutrition apps, were used by 62% of dietitians in their practice, primarily as an information resource (74%) and for patient self-monitoring (60%). The top two nutrition apps recommended were MyFitnessPal® (62%) and the Monash University Low FODMAP Diet® (44%). Text messaging was used by 51% of respondents, mainly for appointment-related purposes (84%). Conclusions Although the reported use of smartphone health apps in dietetic practice is high, health apps and other mHealth technologies are not currently being used for behaviour change, nor are they an integral part of the nutrition care process. Dietetic associations should provide training, education and advocacy to enable the profession to more effectively engage with and implement apps into their practice. [ABSTRACT FROM AUTHOR]

Background Emergency pediatric situations are stressful for all involved. Variation in weight, physiology, and anatomy can be substantial and errors in calculating drugs and fluids can be catastrophic. Objectives To evaluate the reliability of information resources that anesthetic trainees might use when faced with common pediatric emergencies. Methods Anesthetic trainees from a single UK deanery were recruited and timed while they identified 18 predetermined pieces of information from three Advanced Pediatric Life Support ( APLS) scenarios. The two most popular smartphone applications identified from a previous survey, PaedsED (PaedsED. iED limited, Version 1.0.8, Updated March 2011. ©2009) and Anapaed (AnaPaed. Thierry Girard, Version 1.4.2, Updated Nov 2, 2012. ©Thierry Girard), the British National Formulary for Children (c BNF) and trainee's inherent knowledge were compared with a local, check-list style, handbook of pediatric emergency algorithms - Pediatric Anesthetic Emergency Data sheets ( PAEDs). Results Twenty anesthetic trainees were recruited. The fastest source of information was the trainees own knowledge (median 61 s, IQR 51-83 s). Second fastest was PAEDs (80, [59-110] s), followed by Paeds ED (84, [65-111]). The most accurate source overall was Paeds ED (100, [83-100]) although the accuracy varied between scenarios. The handbook was rated as the most popular resource by the trainees. Conclusion Although fastest, trainees own knowledge is inaccurate, highlighting the need for additional, rapidly accessible, information. Of the two smartphone applications, Paeds ED proved to be fast, accurate, and more popular, while Anapaed was accurate but slow to use. The PAEDs handbook, with its checklist-style format, was also fast, accurate and rated the most popular information source. [ABSTRACT FROM AUTHOR]

mHealth tools may be a feasible modality for delivering evidence-based treatments and principles (EBPs), and may enhance treatment for eating disorders (EDs). However, research on the efficacy of mHealth tools for EDs and the extent to which they include EBPs is lacking. The current study sought to (i) review existing apps for EDs, (ii) determine the extent to which available treatment apps utilize EBPs, and (iii) assess the degree to which existing smartphone apps utilize recent advances in smartphone technology. Overall, existing ED intervention apps contained minimal EBPs and failed to incorporate smartphone capabilities. For smartphone apps to be a feasible and effective ED treatment modality, it may be useful for creators to begin taking utilizing the abilities that set smartphones apart from in-person treatment while incorporating EBPs. Before mHealth tools are incorporated into treatments for EDs, it is necessary that the feasibility, acceptability, and efficacy be evaluated. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]