BackgroundThe use of mobile health (mHealth) technologies to improve population-level health outcomes around the world has surged in the last decade. Research supports the use of mHealth apps to improve health outcomes such as maternal and infant mortality, treatment adherence, immunization rates, and prevention of communicable diseases. However, developing countries face significant barriers to successfully implement, sustain, and expand mHealth initiatives to improve the health of vulnerable populations.ObjectiveWe aimed to identify and synthesize barriers to the use of mHealth technologies such as text messaging (short message service [SMS]), calls, and apps to change and, where possible, improve the health behaviors and health outcomes of populations in developing countries.MethodsWe followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Deriving search criteria from the review’s primary objective, we searched PubMed and CINAHL using an exhaustive terms search (eg, mHealth, text messaging, and developing countries, with their respective Medical Subject Headings) limited by publication date, English language, and full text. At least two authors thoroughly reviewed each article’s abstract to verify the articles were germane to our objective. We then applied filters and conducted consensus meetings to confirm that the articles met the study criteria.ResultsReview of 2224 studies resulted in a final group of 30 articles for analysis. mHealth initiatives were used extensively worldwide for applications such as maternal health, prenatal care, infant care, HIV/AIDS prevention, treatment adherence, cardiovascular disease, diabetes, and health education. Studies were conducted in several developing countries in Africa, Asia, and Latin America. From each article, we recorded the specific health outcome that was improved, mHealth technology used, and barriers to the successful implementation of the intervention in a developing country. The most prominent health outcomes improved with mHealth were infectious diseases and maternal health, accounting for a combined 20/30 (67%) of the total studies in the analysis. The most frequent mHealth technology used was SMS, accounting for 18/30 (60%) of the studies. We identified 73 individual barriers and grouped them into 14 main categories. The top 3 barrier categories were infrastructure, lack of equipment, and technology gap, which together accounted for 28 individual barriers.ConclusionsThis systematic review shed light on the most prominent health outcomes that can be improved using mHealth technology interventions in developing countries. The barriers identified will provide leaders of future intervention projects a solid foundation for their design, thus increasing the chances for long-term success. We suggest that, to overcome the top three barriers, project leaders who wish to implement mHealth interventions must establish partnerships with local governments and nongovernmental organizations to secure funding, leadership, and the require...

Online trolling as a form of overt racism forces sociologists to reexamine contemporary understandings of racialization in a color-blind era. In this article, I demonstrate how men of color construct meanings about their experiences of racist hate speech, referred to as trash talk, on an online gaming platform. Analyzing semistructured interviews, I show that respondents cope with this form of racism through a process of desensitization. This strategy is mediated by respondents’ peer socialization on how to effectively manage this racism as men, and their stigmatization by others who do not view these experiences as “real” racism. Strategies to cope with racism in this domain are thus gendered in ways that encourage men of color to remain silent in the face of repeated hate speech. This study further demonstrates how individual strategies developed to navigate racism online are tied to broader, collective understandings of the meanings of race, racisms, and masculinity.

Awareness training can produce decreases in nervous habits during public speaking. A systematic replication of Montes et al. (2020) was conducted to evaluate the independent and additive effects of awareness training components (i.e., response description, response detection) on speech disfluencies during public speaking. We extended prior research by evaluating response description alone, delivering the intervention virtually, using novel videos and speech topics during training, and measuring collateral effects on untargeted responses and speech rate. Response description was sufficient at reducing speech disfluencies for 4 of 9 participants. Response detection (video training) was necessary for 2 participants, and the subsequent addition of response detection (in-vivo training) was necessary for 3 participants. Reductions were maintained during follow-up and generalization probes for most participants. Collateral effects of awareness training components were idiosyncratic. A post-hoc analysis revealed that response description, when effective as a stand-alone intervention, may be more efficient than the full awareness training package.

Rising media and academic concerns for the social implications of online trolling require that scholars understand how everyday users conceptualize trolling. The validity of survey instruments may potentially be at risk if online users and academics, who subsequently advocate for interventions, have competing understandings of trolling. Surveying 120 US-based online users, I find that the spectrum of behaviors classified in the literature as “trolling” do not resonate with respondents. Instead, respondents report that harassment on the basis of race and gender is indicative of trolling. These results suggest a disconnect between academic definitions of trolling that focus on prosocial or humor-based forms of trolling and lay definitions which foreground identity-based harassment and harm. Current instruments that assess trolling behaviors and experiences do not attend to this definition of trolling as identity-based harassment, calling into question construct validity. Furthermore, sociologists identify identity-based harassment as a form of discrimination in other domains of social life, but present measures of discrimination do not consider the online domain. This suggests that studies of everyday discrimination and the implications of mistreatment should extend to online spaces, where racism and sexism are reproduced.

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