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BackgroundInterest in mobile health (mHealth) applications for self-management of diabetes is growing. In July 2009, we found 60 diabetes applications on iTunes for iPhone; by February 2011 the number had increased by more than 400% to 260. Other mobile platforms reflect a similar trend. Despite the growth, research on both the design and the use of diabetes mHealth applications is scarce. Furthermore, the potential influence of social media on diabetes mHealth applications is largely unexplored. ObjectiveOur objective was to study the salient features of mobile applications for diabetes care, in contrast to clinical guideline recommendations for diabetes self-management. These clinical guidelines are published by health authorities or associations such as the National Institute for Health and Clinical Excellence in the United Kingdom and the American Diabetes Association. MethodsWe searched online vendor markets (online stores for Apple iPhone, Google Android, BlackBerry, and Nokia Symbian), journal databases, and gray literature related to diabetes mobile applications. We included applications that featured a component for self-monitoring of blood glucose and excluded applications without English-language user interfaces, as well as those intended exclusively for health care professionals. We surveyed the following features: (1) self-monitoring: (1.1) blood glucose, (1.2) weight, (1.3) physical activity, (1.4) diet, (1.5) insulin and medication, and (1.6) blood pressure, (2) education, (3) disease-related alerts and reminders, (4) integration of social media functions, (5) disease-related data export and communication, and (6) synchronization with personal health record (PHR) systems or patient portals. We then contrasted the prevalence of these features with guideline recommendations. ResultsThe search resulted in 973 matches, of which 137 met the selection criteria. The four most prevalent features of the applications available on the online markets (n = 101) were (1) insulin and medication recording, 63 (62%), (2) data export and communication, 61 (60%), (3) diet recording, 47 (47%), and (4) weight management, 43 (43%). From the literature search (n = 26), the most prevalent features were (1) PHR or Web server synchronization, 18 (69%), (2) insulin and medication recording, 17 (65%), (3) diet recording, 17 (65%), and (4) data export and communication, 16 (62%). Interestingly, although clinical guidelines widely refer to the importance of education, this is missing from the top functionalities in both cases. ConclusionsWhile a wide selection of mobile applications seems to be available for people with diabetes, this study shows there are obvious gaps between the evidence-based recommendations and the functionality used in study interventions or found in online markets. Current results confirm personalized education as an underrepresented feature in diabetes mobile applications. We found no studies evaluating social media concepts in diabetes self-management on mobile devices, and its potential remains largely unexplored.

Common data models provide a standardized way to represent data used in federated learning tasks. The aim of this review was to explore the development and use of common data models to harmonize electronic health record data in health research. The data search yielded 724 records, of which 19 were included for this study. None of the research focused on nursing specific topics. All studies either utilized the Observational Medical Outcomes Partnership (OMOP) common data model, or developed a model partly based on the OMOP. A roadmap to guide research for the development of common data models for federated learning are warranted. [ABSTRACT FROM AUTHOR]

Co-design or participatory design has emerged as a useful concept where stakeholders and end-users have a greater stake in designing the end product. To date, few accounts exist of the use of the concept in serious game design, especially for children with chronic diseases. We report initial steps in serious game co-design for children with type 1 diabetes. Participants included 14 children (mean age 8.6 years, range of 4-13) who were invited to sketch a diabetes game. The most prevalent themes that emerged from the sketches (N=17) include blood glucose monitoring (n=12), nutrition (n=8) and insulin (n=8); all of which are consistent with diabetes education guidelines. Co-design is a promising concept for understanding children’s world-view when designing healthcare games. [ABSTRACT FROM AUTHOR]

While serious games in healthcare have gained much attention in recent years, the pedagogical, social or behavioural frameworks tied to the game elements are still poorly understood. We report the prototyping effort as work-in-progress for a serious social gaming framework for children with diabetes. Motivation theories were combined with child education literature to evaluate potential elements of the framework. Based on the evaluation, we designed cooperation, social comparison and focus on positive achievements as core game elements, and limited the extent of competition. Examining the theoretical foundations that underpin different elements of serious games promises a greater understanding of effective gaming techniques for healthcare. [ABSTRACT FROM AUTHOR]

While Internet communities have become thriving sources of support, little is yet known about their effectiveness. We retrospectively sampled morbidly obese (Body Mass Index, BMI>40) women who were active for at least a year in an Internet community. We compared self-reported weight changes between women who had high online participation levels (n=71) versus those with low participation levels as control (n=69).Women who actively participated online lost on average 7.52%, while those who were passive lost 5.39% of their original body weight. For active women, there was positive, albeit weak, correlation (r=0.22, p<0.05) between online participation levels and weight loss, while no significant correlation was noted for the control. Current results indicate modest evidence supporting active participation in Internet groups as an effective weight loss strategy for the target group. [ABSTRACT FROM AUTHOR]

Although mobile applications and social media have emerged as important facets of the Internet, their role in healthcare is still not well-understood. We present design artefacts, inspired by persuasive technology concepts, from a study of social media as part of a diabetes mHealth application. We used the design science approach for mobile application design, and real-life user testing and focus group meetings to test the application over a 12-week period with 7 participants. Based on the System Usability Score (SUS), the mobile application scored an average of 84.6 (SD=13.2), which represents a fairly high usability score compared to the literature. Regression analysis on the daily blood glucose levels showed significant decreases for some patients, and although the study is not powered, the HbA1c showed a promising trend, and self-efficacy marginally increased. Incorporating persuasive elements such as blood glucose tracking and visualisation, and social media access directly from the mobile application produced promising results that warrant a larger study of behaviour change for people with diabetes. [ABSTRACT FROM AUTHOR]

A health forum is a kind of social network where users share information for specific topics they create. The purpose of this study was the identification of the key actors and the user communities in such a network. We used the publicly available data from a diabetes forum to create the corresponding network and explore several algorithms for the detection of user communities. The degree centrality of the network followed the power law distribution demonstrating that only a few users were the key actors in the forum. It was also shown that it is feasible to infer the top communities from a forum using certain algorithms; the key actors participated in these communities. Our approach could be applied to other health forums and be extended to examine additional aspects. [ABSTRACT FROM AUTHOR]