A Proactive Mobile Health Application Program for Promoting Self-Care Health Management among Older Adults in the Community: Study Protocol of a Three-Arm Randomized Controlled Trial

Abstract

Background: The use of mobile health (mHealth) has become common in recent years and is regarded as one of the most effective interventions for developing disease-specific management skills and establishing confidence in making preventive health behavior changes and accomplishing health-related goals among community-dwelling older adults. Most mHealth designs adopt a reactive care approach whereby health care professionals do not respond until they receive abnormal assessment results from the database or a message or signal from the client. The purpose of this study is to determine the effectiveness of a proactive mobile health application program with the support of a community health-social care team for older adults dwelling in the community on improving their self-care health management. Methods: This is a three-armed, randomized controlled trial. The study will be conducted in 7 community centers with an estimated sample size of 282 participants. The participants will be randomly assigned to mHealth with interactivity, mHealth, and control groups when they are (1) aged 60 or above, (2) complaining chiefly of pain, hypertension, or diabetes mellitus, (3) living within the service areas, and (4) smartphone users. Subjects in the mHealth with interactivity group will receive 2 main elements, the mHealth application and nurse case management supported by a social service team. The mHealth group will receive the mHealth application only. The primary outcome measure will be self-efficacy, and secondary outcomes will include self-management outcomes (pain score, blood pressure, capillary blood glucose), client outcomes (quality of life, depression), and health service utilization outcomes (institutionalization and health service utilization [general practitioner, outpatient clinic, emergency room, hospital admission]). Data will be collected before intervention, after intervention, and 3 months after intervention. Discussion: The incremental benefits of adding interactivity in the mHealth program have not been confirmed. This present study will add valuable information to the knowledge gap of whether mHealth with nurse interaction supported by a health-social partnership can improve self-care management among community-dwelling older adults.

A randomized controlled trial of an mHealth application with nursing interaction to promote quality of life among community-dwelling older adults

“…There were three groups in the study: the mHealth group, the mHealth with interactivity group (mHealth+I), and the control group. Details of the intervention are found in our published protocol ( 24 ).…”

Aplicativos móveis direcionados aos idosos para autogerenciamento do cuidado: revisão de escopo

“…Acrescentaram-se a esses os estudos sobre gerenciamento de práticas saudáveis [21][22][23] . Um dos artigos expôs a relevância do uso de aplicativo móvel entre idosos que vivem em comunidade, auxiliandoos em seus aspectos físico e psicossocial, o que oportuniza o autocuidado 21 .…”

“…Acrescentaram-se a esses os estudos sobre gerenciamento de práticas saudáveis [21][22][23] . Um dos artigos expôs a relevância do uso de aplicativo móvel entre idosos que vivem em comunidade, auxiliandoos em seus aspectos físico e psicossocial, o que oportuniza o autocuidado 21 . examinou a efetividade de ferramenta por meio de informações acerca do tratamento não farmacológico da dor 22 , e exibiu programa que permitiu a realização de atividades para autoavaliação do risco de quedas, pelos beneficiários do serviço, no ambiente doméstico 23 .…”

Telephone and Smartphone-Based Interventions for Cognitive and Cardio-Metabolic Health in Middle-Aged and Older Adults: A Systematic Review

“…Interventions are lasting between 6 weeks to 48 months and studies are including 30 to 2400 participants. Mobile-phone applications are being used in 13 studies [28][29][30][31]52,53 (NCT01307137, NCT04819256, TCTR20211021006, ACTRN12621001136897, ACTRN12621000236897, TCTR20190902004, ISRCTN31471852). For instance, participants with diabetes are using smartphones to record meals and self-monitor weight (NCT04819256).…”