Background For the last 10 years, mobile phones have provided the global health community with innovative and cost-effective strategies to address the challenges in the prevention and management of dengue fever. Objective The aim is to introduce and describe the design and development process of Mozzify, an integrated mobile health (mHealth) app that features real-time dengue fever case reporting and mapping system, health communication (real-time worldwide news and chat forum/timeline, within-app educational videos, links to local and international health agency websites, interactive signs and symptoms checker, and a hospital directions system), and behavior modification (reminders alert program on the preventive practices against dengue fever). We also aim to assess Mozzify in terms of engagement and information-sharing abilities, functionality, aesthetics, subjective quality, and perceived impact. Methods The main goals of the Mozzify app were to increase awareness, improve knowledge, and change attitudes about dengue fever, health care-seeking behavior, and intention-to-change behavior on preventive practices for dengue fever among users. It was assessed using the Mobile Application Rating Scale (MARS) among 50 purposively sampled individuals: public health experts (n=5), environment and health-related researchers (n=23), and nonclinical (end users) participants (n=22). Results High acceptability and excellent satisfaction ratings (mean scores ≥4.0 out of 5) based on the MARS subscales indicate that the app has excellent user design, functionality, usability, engagement, and information among public health experts, environment and health-related researchers, and end users. The app’s subjective quality (recommending the app to other people and the app’s overall star rating), and specific quality (increase awareness, improve knowledge, and change attitudes about dengue fever; health care-seeking behavior; and intention-to-change behavior on preventive practices for dengue fever) also obtained excellent satisfaction ratings from the participants. Some issues and suggestions were raised during the focus group and individual discussions regarding the availability of the app for Android devices, language options limitations, provision of predictive surveillance, and inclusion of other mosquito-borne diseases. Conclusions Mozzify may be a promising integrated strategic health intervention system for dengue fever case reporting and mapping; increase awareness, improve knowledge, and change attitude about dengue fever; and disseminating and sharing information on dengue fever among the general population and health experts. It also can be an effective aid in the successful translation of knowledge on preventive measures against dengue fever to practice.

Communication has such a vital function as the foundation of human social life that speech disabilities can drastically deteriorate people’s quality of life. The author has developed a voice output communication aid (VOCA) to enable children/persons with speech disabilities to communicate with other people according to conversation situations with iOS devices with global positioning system (GPS), positional information acquiring technology (iBeacon), and a clock function installed. The developed technology is an application compatible with iOS (hereinafter, app) that displays a list of messages (hereinafter, VOCA interface) if any of them correspond to the information on the user’s location and time of use as acquired by users with a portable information device with a GPS function, iBeacon function, and clock function installed. Users can communicate by selecting the icons of required messages from VOCA interfaces to reproduce registered voice data instead of their own voices. We have named the developed technology “Friendly VOCA” because its intentions are that: (1) users can communicate with other people with as few operations involved as possible; (2) it should be easy for users to learn and to operate. This paper reports the development processes of the Friendly VOCA and defines the ratios of preregistered VOCA interfaces displayed (hereinafter, correct answer rates) in acquiring positional information with GPS and with iBeacon. In Research Task 1, we have conducted experiments to verify the correct answer rates of the GPS system in outdoor use of the Friendly VOCA and in Research Task 2 we have conducted experiments to verify the correct answer rates of the iBeacon system in indoor use of the Friendly VOCA. The research results show that both the GPS system and iBeacon system can specify user’s spatial information and display appropriate lists of messages. However, the experiments found that iBeacon signal transmitters can transmit signals over a distance of 50 m or more: to improve the correct answer rates of the iBeacon system, we may need to increase the distance between iBeacon signal transmitters or select devices with a shorter range of transmission.

Background Children with profound intellectual and multiple disabilities (PIMD) or severe motor and intellectual disabilities (SMID) only communicate through movements, vocalizations, body postures, muscle tensions, or facial expressions on a pre- or protosymbolic level. Yet, to the best of our knowledge, there are few systems developed to specifically aid in categorizing and interpreting behaviors of children with PIMD or SMID to facilitate independent communication and mobility. Further, environmental data such as weather variables were found to have associations with human affects and behaviors among typically developing children; however, studies involving children with neurological functioning impairments that affect communication or those who have physical and/or motor disabilities are unexpectedly scarce. Objective This paper describes the design and development of the ChildSIDE app, which collects and transmits data associated with children’s behaviors, and linked location and environment information collected from data sources (GPS, iBeacon device, ALPS Sensor, and OpenWeatherMap application programming interface [API]) to the database. The aims of this study were to measure and compare the server/API performance of the app in detecting and transmitting environment data from the data sources to the database, and to categorize the movements associated with each behavior data as the basis for future development and analyses. Methods This study utilized a cross-sectional observational design by performing multiple single-subject face-to-face and video-recorded sessions among purposively sampled child-caregiver dyads (children diagnosed with PIMD/SMID, or severe or profound intellectual disability and their primary caregivers) from September 2019 to February 2020. To measure the server/API performance of the app in detecting and transmitting data from data sources to the database, frequency distribution and percentages of 31 location and environment data parameters were computed and compared. To categorize which body parts or movements were involved in each behavior, the interrater agreement κ statistic was used. Results The study comprised 150 sessions involving 20 child-caregiver dyads. The app collected 371 individual behavior data, 327 of which had associated location and environment data from data collection sources. The analyses revealed that ChildSIDE had a server/API performance >93% in detecting and transmitting outdoor location (GPS) and environment data (ALPS sensors, OpenWeatherMap API), whereas the performance with iBeacon data was lower (82.3%). Behaviors were manifested mainly through hand (22.8%) and body movements (27.7%), and vocalizations (21.6%). Conclusions The ChildSIDE app is an effective tool in collecting the behavior data of children with PIMD/SMID. The app showed high server/API performance in detecting outdoor location and environment data from sensors and an online API to the database with a performance rate above 93%. The results of the analysis and categorization of behaviors suggest a need for a system that uses motion capture and trajectory analyses for developing machine- or deep-learning algorithms to predict the needs of children with PIMD/SMID in the future.

Background While early detection and effective control of epidemics depend on appropriate surveillance methods, the Philippines bases its dengue fever surveillance system on a passive surveillance method (notifications from barangay/village health centers, municipal or city health offices, hospitals, and clinics). There is no available mHealth (mobile health) app for dengue fever that includes all the appropriate surveillance methods in early detection of disease outbreaks in the country. Objective This study aimed to evaluate the usability of the Mozzify app in terms of objective quality (engagement, functionality, aesthetics, information) and app subjective and app-specific qualities and compare total app mean score ratings by sociodemographic profile and self and family dengue fever history to see what factors are associated with high app mean score rating among school-based young adult samples and health care professionals. Individual interviews and focus group discussions were also conducted among participants to develop themes from their comments and suggestions to help structure further improvement and future development of the app. Methods User experience sessions were conducted among participants, and the Mobile Application Rating Scale (MARS) professional and user versions (uMARS) were administered followed by individual interviews and focus group discussions. Descriptive statistical analysis of the MARS and uMARS score ratings was performed. The total app mean score ratings by sociodemographic and dengue fever history using nonparametric mean difference analyses were also conducted. Thematic synthesis was used to develop themes from the comments and suggestions raised in individual interviews and focus group discussions. Results Mozzify obtained an overall >4 (out of 5) mean score ratings in the MARS and uMARS app objective quality (4.45), subjective (4.17), and specific (4.55) scales among 948 participants (79 health care professionals and 869 school-based samples). Mean difference analyses revealed that total app mean score ratings were not significantly different across ages and gender among health care professionals and across age, income categories, and self and family dengue fever history but not gender (P<.001) among the school-based samples. Thematic syntheses revealed 7 major themes: multilanguage options and including other diseases; Android version availability; improvements on the app’s content, design, and engagement; inclusion of users from low-income and rural areas; Wi-Fi connection and app size concerns; data credibility and issues regarding user security and privacy. Conclusions With its acceptable performance as perceived by health care professionals and school-based young adults, Mozzify has the potential to be used as a strategic health intervention system for early detection of disease outbreaks in the Philippines. It can be used by health care professionals of any age and gender and by school-based samples of any age, socioeconomic status, and dengue fever history. The study also highlights the feasibility of school-based young adults to use health-related apps for disease prevention.

Objects: We carried out an investigation to clarify the real state of indoor air pollution by chlorpyrifos (termiticide) and exposure to chlorpyrifos of residents by measuring its urinary metabolite 3,5,6-trichloro-2-pyridinol (TCP) as an exposure index, such as biological monitoring.Methods: The investigation was conducted in 43 individual houses with termiticide application (whether the termiticide was chlorpyrifos is uncertain) and 3 control houses without any termiticide application in Kagawa, Japan. Urine samples were collected from 46 healthy adult residents of the aforementioned houses.Results: Chlorpyrifos in indoor air in the control houses was not detected (ND<1 ng/m 3 , n=3), while 41 of 43 houses with termiticide application showed 1-350 ng/m 3 . Although the chlorpyrifos concentrations in these 41 houses did not exceeded the indoor air quality guideline of 1000 ng/m 3 , but 3 houses were higher than the guideline 100 ng/m 3 for children in Japan. Urinary TCP concentrations of 0.1-7.8 ng/mg·creatinine were detected in 41 residents from the 41 houses where chlorpyrifos had been detected. The chlorpyrifos concentration and the urinary TCP revealed a positive correlation (r=0.5468, p<0.01, n=41).Conclusions: The immediate health hazard from air born chlorpyrifos in the examined houses was negligible, but the findings suggest that it is necessary to monitor chemicals which may contaminate indoor air and to assess the risk of prolonged exposure to such chemicals. The measuring of urinary metabolite TCP of chlorpyrifos via biological monitoring would be useful, allowing comprehensive evaluation of the exposure to chlorpyrifos in indoor air.