Individual and Parental Factors of Adolescents’ mHealth App Use: Nationally Representative Cross-sectional Study

Güleç, Hayriye; Ŝmahel, David

doi:10.2196/40340

Cited by 9 publications

(5 citation statements)

References 39 publications

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“…For example, female adolescents have been shown to be more willing to report symptoms after concussion [ 33 ] and with greater frequency [ 6 ]. Particularly in digital use, female adolescents were found to have stronger motives for interpersonal communication and self-expression than male adolescents [ 34 35 ], which may explain why higher response rates were observed in female adolescents while using the mHealth app in this study.…”

Section: Discussionmentioning

confidence: 99%

Response Rate Patterns in Adolescents With Concussion Using Mobile Health and Remote Patient Monitoring: Observational Study

Ren,

McDonald,

Corwin

et al. 2024

JMIR Pediatr Parent

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Background A concussion is a common adolescent injury that can result in a constellation of symptoms, negatively affecting academic performance, neurobiological development, and quality of life. Mobile health (mHealth) technologies, such as apps for patients to report symptoms or wearables to measure physiological metrics like heart rate, have been shown to be promising in health maintenance. However, there is limited evidence about mHealth engagement in adolescents with a concussion during their recovery course. Objective This study aims to determine the response rate and response rate patterns in concussed adolescents reporting their daily symptoms through mHealth technology. It will also examine the effect of time-, demographic-, and injury-related characteristics on response rate patterns. Methods Participants aged between 11-18 years (median days since injury at enrollment: 11 days) were recruited from the concussion program of a tertiary care academic medical center and a suburban school’s athletic teams. They were asked to report their daily symptoms using a mobile app. Participants were prompted to complete the Post-Concussion Symptom Inventory (PCSI) 3 times (ie, morning, afternoon, and evening) per day for 4 weeks following enrollment. The primary outcome was the response rate pattern over time (by day since initial app use and the day since injury). Time-, demographic-, and injury-related differences in reporting behaviors were compared using Mann Whitney U tests. Results A total of 56 participants were enrolled (mean age 15.3, SD 1.9 years; n=32, 57% female). The median response rate across all days of app use in the evening was 37.0% (IQR 27.2%-46.4%), which was significantly higher than the morning (21.2%, IQR 15.6%-30.5%) or afternoon (26.4%, IQR 21.1%-31.5%; P<.001). The median daily response was significantly different by sex (female: 53.8%, IQR 46.2%-64.2% vs male: 42.0%, IQR 28.6%-51.1%; P=.003), days since injury to app use (participants starting to use the app >7 days since injury: 54.1%, IQR 47.4%-62.2% vs starting to use the app ≤7 days since injury: 38.0%, IQR 26.0%-53.3%; P=.002), and concussion history (participants with a history of at least one prior concussion: 57.4%, IQR 44.5%-70.5% vs participants without concussion history: 42.3%, IQR 36.8%-53.5%; P=.03). There were no significant differences by age. Differences by injury mechanism (sports- and recreation-related injury: 39.6%, IQR 36.1%-50.4% vs non–sports- or recreation-related injury: 30.6%, IQR 20.0%-42.9%; P=.04) and initial symptom burden (PCSI scores greater than the median score of 47: 40.9%, IQR 35.2%-53.8% vs PCSI scores less than or equal to the median score: 31.9%, IQR 24.6%-40.6%; P=.04) were evident in the evening response rates; however, daily rates were not statistically different. Conclusions Evening may be the optimal time to prompt for daily concussion symptom assessment among concussed adolescents compared with morning or afternoon. Multiple demographic- and injury-related characteristics were associated with higher daily response rates, including for female participants, those with more than 1 week from injury to beginning mHealth monitoring, and those with a history of at least one previous concussion. Future studies may consider incentive strategies or adaptive digital concussion assessments to increase response rates in populations with low engagement.

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Section: Discussionmentioning

confidence: 99%

Response Rate Patterns in Adolescents With Concussion Using Mobile Health and Remote Patient Monitoring: Observational Study

Ren,

McDonald,

Corwin

et al. 2024

JMIR Pediatr Parent

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“…These skills, triangulation and fact-checking sources, are not captured in the current eHEALS and may be useful to assess in addition to, or in a revised version of, the eHEALS. Given that adolescents use health-related mobile applications to monitor their health behavior (Gulec & Smahel, 2022; Wartella et al, 2016), a revised version of the eHEALS should also assess eHL skills associated with the navigation and application of health information from mobile applications. These expansions in the assessment of eHL skills may address the ceiling effect problem of the eHEALS.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, a meta-analysis by Kim et al (2023) found a moderate correlation between eHL and several health behaviors. Among adolescents, higher eHL skills have been associated with nutrition, stress management, and exercise behaviors (Korkmaz Aslan et al, 2021) as well as higher frequency of using mHealth apps (e.g., apps to track calorie intake/expenditure; Gulec & Smahel, 2022). Low eHL has been linked to lower likelihood of online information-seeking in adolescents (Chang et al, 2015; Ghaddar et al, 2012).…”

Section: Ehealth Literacymentioning

confidence: 99%

Construct Validity and Measurement Invariance of the eHEALS in a Diverse US High School Sample

Joseph,

Fleary

2024

Journal of Media Psychology

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Although the eHealth Literacy Scale (eHEALS) is a widely used measure of eHealth literacy (eHL), it has not been validated in a diverse sample of US adolescents. This study assessed the construct validity and item and measurement invariance of the eHEALS using both Rasch analyses and classical test theory (CTT). Data were collected from adolescents at a US Northeastern high school ( N = 355, 64.9% were 16–18-years old, 54.8% male, 76.4% from a racially minoritized group, and 50.5% Latinx). Adolescents completed a survey that included demographic variables (i.e., age in years, gender, and ethnicity) and the eHEALS. Using Rasch and CTT methodologies, the dimensionality of the eHEALS and item and measurement invariance across gender, age, and ethnicity were assessed. The unidimensional structure of the eHEALS as well as item and measurement invariance across gender, age, and ethnicity were supported. Rasch analyses also suggested that responses to eHEALS items can be summed to determine eHL abilities, although there was a ceiling effect. The eHEALS is a unidimensional measure of eHL that may provide information in health education settings about adolescents’ eHL skills. It performs similarly across male and female as well as older and younger adolescents. However, given the ceiling effect and changes in adolescents’ Internet use since its development, future studies should revise the eHEALS to better capture adolescents’ eHL abilities. Future studies should also examine item and measurement invariance by age (in years), race, family income, and longitudinally to determine the usefulness of the measure across groups and time.

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“…These would help the users know their health status, namely health awareness. 34 The BeWS-SPA program uses a notification system to encourage users to assess their daily stress levels. In addition, the researchers developed this app by considering the limitations or related problems in the app functions in a previous study and adjusting for better functions.…”

Section: Discussionmentioning

confidence: 99%

Promoting Positive Thinking and Reducing Perceived Stress Using the Be Aware of Stress Smartphone Application among At-risk Adolescents: A Quasi-experimental Study.

Hengudomsub,

Sudjai,

Kangwanphanit

et al. 2024

PRIJNR

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It is estimated that globally, millions of adolescents experience mental health problems, especially anxiety and depression. Adolescents with high perceptions of stress often encounter mental issues, have negative thoughts or are dissatisfied with daily life events. This study employed a quasi-experimental design with two groups and repeated measures to test an innovative nursing intervention, the Be Aware of Stress Smartphone Application. This application aims to increase positive thinking and reduce perceived stress among at-risk adolescents aged 13 to 16, and we sought to determine their satisfaction with its usability. The study was conducted with 44 junior high school students from an opportunity expansion high school in Eastern Thailand, who were randomly assigned to experimental and comparison groups (22 each). Data were collected between December 2023 and February 2024 using the General Information Questionnaire, Positive Thinking Test, Perceived Stress Questionnaire, and Satisfaction of Application Usability scale. The outcomes were measured at baseline, after completing the program at week 4, and at week 8 after using the application. The chi-square test and repeated measures analysis of variance were used to analyze the data. The results of this study have important implications for future research. They indicate a significant improvement in positive thinking and a reduction in perceived stress within the experimental group, compared to the comparison group, at weeks 4 and 8. Moreover, the experimental group reported high satisfaction with the application’s usability. These findings suggest that the Be Aware of Stress application is beneficial for community nurses and others to prevent adolescent stress. The study also highlights the need for future research to enhance the application’s functionality and compatibility with various phone operating systems to ensure widespread and effective use.

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Individual and Parental Factors of Adolescents’ mHealth App Use: Nationally Representative Cross-sectional Study

Cited by 9 publications

References 39 publications

Response Rate Patterns in Adolescents With Concussion Using Mobile Health and Remote Patient Monitoring: Observational Study

Response Rate Patterns in Adolescents With Concussion Using Mobile Health and Remote Patient Monitoring: Observational Study

Construct Validity and Measurement Invariance of the eHEALS in a Diverse US High School Sample

Promoting Positive Thinking and Reducing Perceived Stress Using the Be Aware of Stress Smartphone Application among At-risk Adolescents: A Quasi-experimental Study.

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