While digital health or mHealth applications (apps) have become accessible resources for the support of personal health, the privacy and security of users' data have been the subject of concern and controversy. As large numbers of mHealth apps are created and are increasingly widely used by people with various health conditions, it is crucial to have clear and valid methods for evaluating the data practices within them. Recent regulatory initiatives such as the European Union's General Data Protection Regulation (GDPR) and California Consumer Privacy Act (CCPA) have had the effect of raising awareness and establishing a minimal set of expectations. However, they do not in themselves address the issue of the development of systems which meet privacy and security requirements. There is a growing body of research on evaluation techniques and frameworks to support the assessment of the privacy and security of health apps, and guidelines to support their design. However, it can be challenging to navigate this space and choose appropriate techniques for a given context. Addressing this issue, this paper examines the recent literature on security and privacy of m-Health applications, using a scoping review methodology. It analyses data security and privacy evaluation techniques and frameworks that have been proposed for mHealth applications, as well as relevant research-based design recommendations. This work consolidates recent research on the topic to support researchers, app designers, end users, and healthcare professionals in designing, evaluating, recommending and adopting mHealth applications.

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Despite the benefits, one in three older adults in Ireland has low activity levels. This study examined associations between the local social and built environment and physical activity of older adults to identify age-friendly factors that support physical activity among the aging population. Data were from the population-representative Healthy and Positive Ageing Initiative Age-Friendly City and Counties Survey (N = 10,540). Physical activity was measured using a short-form of the International Physical Activity Questionnaire. Mixed-effects negative binomial regression models were adjusted for known health and sociodemographic correlates of physical activity. Results are reported as unstandardized beta coefficients (β) with standard errors. Loneliness, community participation, and difficulty in accessing green spaces partially explained the differences in the number of minutes that respondents were physically active. Combined with individual-level behavior change interventions, improvements to the local environment and promoting social connectedness may also be useful in promoting physical activity among older adults.

IntroductionTechnological innovation has been pervasive and has touched almost every aspect of modern life, including the delivery of behavioural and mental heath care. As telehealth expands, internet interventions are particularly interesting as a medium of delivering effective care. However, standards are required to help inform healthcare policy makers, providers, clinicians and patients.ObjectiveMove towards outlining a gold standard for internet-delivered behavioural and mental health interventions.AimsContribute and build upon existing standards and guidelines for the practice of telehealth, but to now extend these to include internet-delivered interventions.MethodsDrawing from research, experience and practice, the authors propose a matrix for the evaluation of what might be considered a gold standard for internet-delivered behavioural and mental health interventions.ResultsSeven elements are proposed and considered aspects of what would constitute a gold standard and they include, the use of evidence-based and empirically supported content, robust, engaging, secure and responsive technologies, shaped by behavioural health subject matter experts, employ user-centred design and development principles, have a focus on accountable care-achieving clinical outcomes, have research and evaluation that supports its effectiveness, and a well developed implementation science and support.ConclusionThe paper proposes some characteristics that could compose a gold standard for internet-delivered interventions for behavioural and mental health care. The contribution is neither exhaustive nor conclusive, but offers an invitation to the discussion.Disclosure of interestThe authors have not supplied their declaration of competing interest.

BackgroundOverweight and obesity is related to many health problems and diseases. The current obesity epidemic, which is a major health problem, is closely related to a lack of physical activity, high levels of sedentary behavior, and increased energy intake; with evidence to show increasing incidence of these issues in the younger population. Tackling obesity and its comorbid conditions requires a holistic approach encompassing attention on physical activity, healthy diet, and behavioral activation in order to enable and maintain meaningful and long-term weight loss and weight maintenance.ObjectiveThe objective of the Data-as-a-Service Platform for Healthy Lifestyle and Preventive Medicine (DAPHNE) project is to develop a breakthrough information communications technology (ICT) platform for tracking health, weight, physical activity, diet, lifestyle, and psychological components within health care systems, whereby the platform and clinical support is linked.MethodsThe DAPHNE platform aims to deliver personalized guidance services for lifestyle management to the citizen/patient by means of (1) advanced sensors and mobile phone apps to acquire and store continuous/real-time data on lifestyle aspects, behavior, and surrounding environment; (2) individual models to monitor their health and fitness status; (3) intelligent data processing for the recognition of behavioral trends; and (4) specific services for personalized guidance on healthy lifestyle and disease prevention. It is well known that weight loss and maintenance of weight loss are particularly difficult. This tool will address some of the issues found with conventional treatment/advice in that it will collect data in real time, thereby reducing reliability issues known with recalling events once they have passed and will also allow adjustment of behavior through timely support and recommendations sent through the platform without the necessity of formal one-to-one visits between patient and clinician. Patient motivation/compliance is a particular issue with conventional weight loss regimes; DAPHNE aims to increase the individuals’ awareness of their own behavior and fosters their accountability.ResultsThe project has been funded and the research work has started. Results for the validation of the different components is due imminently.ConclusionsIn contrast with previous existing solutions, the DAPHNE project tackles the obesity problem from a clinical point of view, designing the different interfaces for its use by patients (adults and children), physicians, and caregivers. A specific design for children and adolescent patients treated for obesity has been followed, guided by pediatric physicians at hospitals in Europe. The final clinical validation of the DAPHNE platform will be carried out in different European hospitals, testing the platform in both adolescents and adults.