Effectiveness of an mHealth application to improve hypertension health literacy in India

Garner, Shelby L.; George, Caroline; Young, Phil D.; Hitchcock, Julia; Koch, Hope; Green, G.; Mahid, Zonayed; Norman, Gift

doi:10.1111/inr.12616

Cited by 27 publications

(57 citation statements)

References 22 publications

(27 reference statements)

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“…Despite best efforts, limited medical resources and time make it difficult to educate patients and meet their individual needs in traditional face-to-face interventions [ 50 ]. The advantage of the mHealth service comes from its high scalability for providing services, for example, disseminating a large amount of educational material to a wide range of patients with hypertension for effective health education for chronic disease management [ 51 - 53 ]. It also allows these patients to absorb the information in their own time and at their own pace until they are fully aware of the importance and have the ability to perform self-management.…”

Section: Discussionmentioning

confidence: 99%

A Comprehensive 6A Framework for Improving Patient Self-Management of Hypertension Using mHealth Services: Qualitative Thematic Analysis

et al. 2021

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Background Hypertension affects over 15% of the world’s population and is a significant global public health and socioeconomic challenge. Mobile health (mHealth) services have been increasingly introduced to support hypertensive patients to improve their self-management behaviors, such as adherence to pharmacotherapy and lifestyle modifications. Objective This study aims to explore patients’ perceptions of mHealth services and the mechanisms by which the services support them to self-manage their hypertension. Methods A semistructured, in-depth interview study was conducted with 22 outpatients of the General Hospital of Ningxia Medical University from March to May 2019. In 2015, the hospital introduced an mHealth service to support community-dwelling outpatients with self-management of hypertension. Content analysis was conducted by following a grounded theory approach for inductive thematic extraction. Constant comparison and categorization classified the first-level codes with similar meanings into higher-level themes. Results The patient-perceived mechanisms by which the mHealth service supported their self-management of hypertension were summarized as 6A: access, assessment, assistance, awareness, ability, and activation. With the portability of mobile phones and digitization of information, the mHealth service provided outpatients with easy access to assess their vital signs and self-management behaviors. The assessment results gave the patients real-time awareness of their health conditions and self-management performance, which activated their self-management behaviors. The mHealth service also gave outpatients access to assistance, which included health education and self-management reminders. Both types of assistance could also be activated by abnormal assessment results, that is, uncontrolled or deteriorating blood pressure values, discomfort symptoms, or not using the service for a long period. With its scalable use to handle any possible information and services, the mHealth service provided outpatients with educational materials to learn at their own pace. This led to an improvement in self-management awareness and ability, again activating their self-management behaviors. The patients would like to see further improvements in the service to provide more useful, personalized information and reliable services. Conclusions The mHealth service extended the traditional hypertension care model beyond the hospital and clinician’s office. It provided outpatients with easy access to otherwise inaccessible hypertension management services. This led to process improvement for outpatients to access health assessment and health care assistance and improved their awareness and self-management ability, which activated their hypertension self-management behaviors. Future studies can apply the 6A framework to guide the design, implementation, and evaluation of mHealth services for outpatients to self-manage chronic conditions.

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Section: Discussionmentioning

confidence: 99%

A Comprehensive 6A Framework for Improving Patient Self-Management of Hypertension Using mHealth Services: Qualitative Thematic Analysis

et al. 2021

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“…In recent years, there is an ever‐growing percentage of the world population that uses Internet‐associated technologies to seek health‐relevant information and manage their health (Kim & Xie 2017, Kostagiolas et al, 2016, Garner et al 2021). Building on existing conceptualizations and various definitions of health literacy (Ayaz‐Alkaya et al 2020; Griebel et al 2018), we can describe as electronic health (ehealth) literacy, all essential skills needed to locate, understand, use, and evaluate electronic, web‐based and mobile resources to make informed choices regarding health promotion and disease prevention and management.…”

Section: Introductionmentioning

confidence: 99%

Nurses’ ehealth literacy and associations with the nursing practice environment

Kritsotakis

Andreadaki

Linardakis

et al. 2021

International Nursing Review

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Aim To report on ehealth literacy levels in nurses and to explore its associations with the nursing practice environment. Background Nurses increasingly use the Internet and associated technologies to seek health‐relevant information and manage their health. Introduction High ehealth literacy is a predictor of better health outcomes in diverse populations but its levels and work‐related determinants have not been adequately explored in direct‐care nurses. Methods The sample for this cross‐sectional study consisted of 200 staff nurses and nursing assistants in Greece. Participants reported during February–March 2019 their sociodemographic and work‐related characteristics on a self‐administered questionnaire which included the “electronic Health Literacy Scale”—eHEALS, and the “Practice Environment Scale of the Nursing Work Index”—PES‐NWI. Crude and adjusted logistic regressions were performed. Findings In adjusted models, participants that scored higher on the “Collegial nurse–physician relationships” and “Nurse participation in hospital affairs” dimensions of the clinical environment had higher odds of reporting better ehealth literacy. The lowest item score in eHEALS was related to not being able to make health decisions using Internet information. Discussion Nurses’ ehealth literacy was positively associated with some dimensions of the hospital practice environment. Nurses reported higher ehealth literacy scores in comparison to other studies; however, they were not confident in distinguishing reliable health information from Internet sources. This is quite alarming because it can directly impair the ability of nurses to provide relevant and up‐to‐date evidence‐based care. Conclusion This is the first study to report internationally on the positive associations of a good working environment with nurses’ ehealth literacy levels. Implications for Nursing and Nursing Policy Nursing policy should address the ehealth literary of nurses and integrate it into continuing professional education initiatives. Special focus should be put on nurses’ ambiguity in distinguishing which ehealth information is reliable and can guide nursing practice. This should be combined with efforts to improve the nursing clinical environment and increase nurses’ participation in hospital decisions.

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“…This is consistent with findings by other researchers who used videos as part of their intervention. 51,52 Although no professional actors were employed, the cast delivered performances that resonated with the audience, as one participant so eloquently called it, "Real people telling it like it is. " The use of role-playing, keeping the videos short (under three minutes), as well as professional directing, lighting, and editing contributed to creating an engaging experience.…”

Section: Discussionmentioning

confidence: 99%

Managing Technology, Content, and User Experience: An mHealth Intervention to Improve Women's Health Literacy after Incarceration

Geana¹,

Anderson²,

Lipnicky³

et al. 2021

Journal of Health Care for the Poor and Underserved

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E very year, more than 3.2 million women come into contact with the criminal legal system in the United States. 1 Representing the fastest-growing incarcerated group, women with criminal legal histories are more likely to report chronic conditions, such as cancer, hypertension, heart disease, and diabetes. 2 Around 67% of females in jails reported ever having a chronic condition. 3 On top of these health issues, many women are affected by sexual trauma, poverty, drug addition, mental illness, and limited access to medical care. 4 The majority of incarcerated women are between the ages of 18 and 44. 1 Women with incarceration histories bear a greater burden of sexual and reproductive health problems such as abnormal Pap test histories, cervical cancer, unintended pregnancies, and sexually transmitted infections (STIs). 1,5,6 In addition, there is a growing number of women in jails and prisons who are 55 and older, a group of women who have lower rates of up-to-date mammograms compared with the general population. 7,8 When released from jail, women must face these and other health and social problems as they reorient themselves back into the community. 9,10 Community reentry presents an opportune moment for health intervention in that it gets women to think about changing circumstances at a high-risk time 11 and may provide women with resources to see those changes through. Researchers have found that women with past criminal legal histories are often savvy health care users, though woefully underinsured in some regions of the U.S. 12 Although most incarcerated women are knowledgeable about behavioral health issues to some extent, many have beliefs about women's health that are outdated, often affected by family, medical, or social beliefs about screening regimens, or in some cases their own trauma histories. 13 These

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Effectiveness of an mHealth application to improve hypertension health literacy in India

Cited by 27 publications

References 22 publications

A Comprehensive 6A Framework for Improving Patient Self-Management of Hypertension Using mHealth Services: Qualitative Thematic Analysis

A Comprehensive 6A Framework for Improving Patient Self-Management of Hypertension Using mHealth Services: Qualitative Thematic Analysis

Nurses’ ehealth literacy and associations with the nursing practice environment

Managing Technology, Content, and User Experience: An mHealth Intervention to Improve Women's Health Literacy after Incarceration

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