Utilizing a Mobile Health Intervention to Manage Hypertension in an Underserved Community

2019 ◽  
Vol 42 (3) ◽  
pp. 201-209
Author(s):  
Peijia Zha ◽  
Rubab Qureshi ◽  
Sallie Porter ◽  
Ying-Yu Chao ◽  
Dula Pacquiao ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Urban Communities ◽  
Mobile Health ◽  
Self Efficacy ◽  
Controlled Trial ◽  
Self Monitoring ◽  
Mhealth Intervention ◽  
Related Quality ◽  
Health Related

This 6-month pilot randomized controlled trial examined the effectiveness of a Mobile Health (mHealth) intervention for hypertension self-monitoring and management in an underserved urban community. The four health outcomes measured included changes in systolic and diastolic blood pressure (BP), BP monitoring adherence, perceived medication adherence self-efficacy, and health-related quality of life. Thirty participants were randomly assigned to the mHealth group or a standard follow-up group; 25 participants completed the study. The mHealth group had statistically significant improvement in systolic BP decrease ( p = .01). The mHealth group had better adherence to BP monitoring and improved perceived medication adherence self-efficacy at 6 months, compared with the standard follow-up group. The results suggest that an mHealth intervention has the potential to facilitate hypertension management in underserved urban communities.

Effectiveness of a Guided Internet- and Mobile-Based Intervention for Patients with Chronic Back Pain and Depression (WARD-BP): A Multicenter, Pragmatic Randomized Controlled Trial

2020 ◽  
pp. 1-14
Author(s):  
Harald Baumeister ◽  
Sarah Paganini ◽  
Lasse Bosse Sander ◽  
Jiaxi Lin ◽  
Sandra Schlicker ◽  
...  
Keyword(s):  
Care Setting ◽  
Chronic Back Pain ◽  
Controlled Trial ◽  
Work Capacity ◽  
Routine Care ◽  
Randomized Controlled ◽  
Related Quality ◽  
Health Related

<b><i>Introduction:</i></b> There is neither strong evidence on effective treatments for patients with chronic back pain (CBP) and depressive disorder nor sufficiently available mental health care offers. <b><i>Objective:</i></b> The aim is to assess the effectiveness of internet- and mobile-based interventions (IMI) as a scalable approach for treating depression in a routine care setting. <b><i>Methods:</i></b> This is an observer-masked, multicenter, pragmatic randomized controlled trial with a randomization ratio of 1:1.<b><i></i></b>Patients with CBP and diagnosed depressive disorder (mild to moderate severity) were recruited from 82 orthopedic rehabilitation clinics across Germany. The intervention group (IG) received a guided depression IMI tailored to CBP next to treatment-as-usual (TAU; including medication), while the control group (CG) received TAU. The primary outcome was observer-masked clinician-rated Hamilton depression severity (9-week follow-up). The secondary outcomes were: further depression outcomes, pain-related outcomes, health-related quality of life, and work capacity. Biostatistician blinded analyses using regression models were conducted by intention-to-treat and per protocol analysis. <b><i>Results:</i></b> Between October 2015 and July 2017, we randomly assigned 210 participants (IG, <i>n</i> = 105; CG, <i>n</i> = 105), mostly with only a mild pain intensity but substantial pain disability. No statistically significant difference in depression severity between IG and CG was observed at the 9-week follow-up (β = –0.19, 95% CI –0.43 to 0.05). Explorative secondary depression (4/9) and pain-related (4/6) outcomes were in part significant (<i>p</i> &#x3c; 0.05). Health-related quality of life was significantly higher in the IG. No differences were found in work capacity. <b><i>Conclusion:</i></b> The results indicate that an IMI for patients with CBP and depression in a routine care setting has limited impact on depression. Benefits in pain and health-related outcomes suggest that an IMI might still be a useful measure to improve routine care.

scholarly journals Predictors of health-related quality of life in Chinese patients receiving treatment for neovascular age-related macular degeneration: A Prospective Longitudinal study

2020 ◽  
Author(s):  
Wei Bian ◽  
Junli Wan ◽  
Mingqiong Tan ◽  
Jun Su ◽  
Yi Yuan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Social Support ◽  
Self Efficacy ◽  
Age Related Macular Degeneration ◽  
Health Related Quality ◽  
Age Related ◽  
Related Quality ◽  
Health Related

Abstract Background: Age-related macular degeneration (AMD) is currently the leading cause of irreversible visual impairment in developed countries and seriously affects the health-related quality of life (HRQoL) of patients. However, the majority of the research in this area employs cross-sectional design; longitudinal research investigating changes in HRQoL and influencing factors is limited. The aim of this study was to use a longitudinal study design to investigate descriptive trends in HRQoL and their predictive factors in Chinese AMD patients receiving treatment with vascular endothelial growth factor inhibitors (anti-VEGF) at baseline and follow-ups.Methods: In a sample of 142 AMD patients from the outpatient clinic of the Southwest Eye Hospital, a tertiary major hospital in the southwest of China, each patient completed a self-administered questionnaire assessing demographics, clinical features, HRQoL, depression, anxiety, coping style, social support, and self-efficacy at baseline and at 1-, 3-, 6-, and 12-month follow-up appointments.Results: The total score of HRQoL fluctuated, with the highest score at the 6-month follow-up and the lowest score at baseline. Multivariable linear regression showed the predictors of HRQoL are best-corrected visual acuity (BCVA), income level, depression, and visual acuity (VA) of the treated eye at baseline; BCVA, income, and depression at the 1-month follow-up; duration, area of residence, gender, VA of the treated eye, BCVA, income, anxiety, social support, self-efficacy, and depression at the 3-month follow-up; gender, BCVA, income, anxiety, social support, self-efficacy, depression, negative coping, and positive coping at the 6-month follow-up; and BCVA, social support, self-efficacy, and depression at the 12-month follow-up.Conclusions: The HRQoL and its predictive factors in Chinese AMD patients receiving anti-VEGF treatment fluctuated over time. It is suggested that medical staff should get more information when planning precise care for improving patients’ HRQoL.

scholarly journals The extent of endoscopic sinus surgery in patients with severe chronic rhinosinusitis with nasal polyps (AirGOs Operative)

2021 ◽  
Vol 4 (4) ◽  
pp. 154-160
Author(s):  
M.J. Lilja ◽  
P. Virkkula ◽  
S. Hammaren-Malmi ◽  
A. Laulajainen-Hongisto ◽  
L. Hafren ◽  
...  
Keyword(s):  
Nasal Polyps ◽  
Controlled Trial ◽  
Sinus Surgery ◽  
Health Related Quality ◽  
Randomized Controlled ◽  
Related Quality ◽  
Health Related ◽  
Snot 22

Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic inflammatory disease of the nose and paranasal sinuses characterized by intense inflammation, decreased health-related quality of life (HRQoL), and in severe cases high frequency of co-morbidities and recurrence despite treatment. Conservative treatment consists of nasal lavage, intranasal corticosteroids, and courses of oral corticosteroids, and antibiotics in exacerbations. Endoscopic sinus surgery (ESS) and/or biological therapy is considered if appropriate conservative treatment is not sufficient. The optimal extent of ESS in recalcitrant CRSwNP is not known. The aim of this randomized controlled trial is to evaluate and compare the efficacy and safety of limited ESS with partial ethmoidectomy with extended ESS with total ethmoidectomy in patients with severe CRSwNP. Methods: AirGOs Operative is a randomized controlled trial. It is an investigator-driven multicenter trial led by Helsinki University Hospital. The two surgery arms are compared. The primary outcome is the change in the SNOT-22 score at the 12-month follow-up. Secondary outcomes include the change in the SNOT-22 score at 24-months follow-up, the changes in polyp score, Lund-Mackay (LM) CT score, health-related quality of life (HRQoL), loss of productivity, nasal patency (peak nasal inspiratory flow (PNIF) ± acoustic rhinometry (ARM), olfaction test (Sniffin’ Sticks, identification), lung function (spirometry and PEF) and findings in pathological analysis at 12/24-months follow-up. Discussion: AirGOs Operative trial will lead to a better understanding of the optimal extent of ethmoidectomy in the treatment of recalcitrant severe CRSwNP.

The Effect of Health Literacy, Self-management Behavior, Self-efficacy and Social Support on the Health-related Quality of Life of Kazakh Hypertension Patients in a Low-income Rural Area of China: a structural Equation Model

2020 ◽  
Author(s):  
Qinghua Zhang ◽  
Feifei Huang ◽  
Lei Zhang ◽  
Shasha Li ◽  
Jingping Zhang
Keyword(s):  
Social Support ◽  
Medication Adherence ◽  
Structural Equation Model ◽  
Self Efficacy ◽  
Structural Equation ◽  
Equation Model ◽  
Self Management ◽  
Management Behavior ◽  
Related Quality ◽  
Health Related

Abstract Background Considering the High Blood Pressure-Health Literacy (HBP-HL) has not been included in the study of Health-Related Quality of Life (HRQoL). The synergistic effects and the potential mechanism HBP-HL, self-management behavior, medication adherence, self-efficacy, social support on HRQoL remain unclear. This study aimed to introduce the conception of HBP-HL, and develop a structural equation model to identify the factors influencing of the HRQoL among Kazakh hypertensive patients. Methods A cross-sectional investigation study was conducted to collect data. Patients with hypertension were recruited through random cluster sampling in Kazakh settlements in Urumqi County, Xinjiang. The one-on-one household interviews were conducted by Kazakh investigators. The questionnaires regarding HBP-HL, HRQoL, self-management behavior, medication adherence, self-efficacy, and social support were collected. In addition, the results of physical examination were also included. A structural equation model was used to assess the association between the measured factors and HRQoL. Results 516 Kazakh patients were recruited, and 94.4% of them had a relatively low HBP-HL score. The mean standardized scores of HRQoL, self-management, medication adherence were poor; they were 63.5, 66.2, and 64.4, respectively. But 96.1% and 98.3% of the participants had high levels of self-efficacy and social support. The structural equation model of the HRQoL had a good overall fit (χ2/df = 2.078, AGFI = 0.944, GFI = 0.968, CFI = 0.947, IFI = 0.949, RMSEA = 0.046). The model indicated that the HBP-HL has the highest correlation with HRQoL, following with self-management behavior, social support, and self-efficacy. Conclusions Evidence from this study demonstrates that low HBP-HL is a major influenced factor of HRQoL among Kazakh hypertensive patients. Future programs should consider HBP-HL as the breakthrough point when designing targeting intervention strategies for Kazakh hypertension patients. Firstly, researchers should give a priority to evaluate patient’s HBP-HL before intervention. Next, tailored interventions are implemented for patients, and and ultimately it will contribute to control blood pressure and improve patients’ HRQoL.

Preschoolers’ health-related quality of life following the implementation of a childcare physical activity intervention

2018 ◽  
Vol 43 (5) ◽  
pp. 453-459 ◽  
Author(s):  
Stephanie Truelove ◽  
Andrew M. Johnson ◽  
Leigh M. Vanderloo ◽  
Molly Driediger ◽  
Shauna M. Burke ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Controlled Trial ◽  
Health Related Quality ◽  
Post Intervention ◽  
Related Quality ◽  
Health Related ◽  
The Impact

Being active offers many physical and emotional benefits contributing to a higher health-related quality of life (HRQoL); however, this relationship remains unexplored among preschoolers (aged 2.5–5 years). This study examined the impact of the Supporting Physical Activity in the Childcare Environment (SPACE), which was an intervention implemented using a cluster randomized controlled trial on preschoolers’ HRQoL. Childcare centres were randomly allocated to the experimental (n = 11) or control (n = 11) conditions, and preschoolers’ HRQoL was measured using the parent-report Pediatric Quality of Life Inventory 4.0 (3 subscales: physical, psychosocial, and total HRQoL) at baseline, post-intervention (i.e., week 8), and 6- and 12-month follow-up. A linear mixed-effects model was used to determine if preschoolers in the experimental condition displayed an increased HRQoL post-intervention and at follow-up compared with preschoolers in the control condition. Preschoolers (n = 234) with HRQoL data at baseline and one additional time-point were retained for analyses. Body mass index was not found to impact significantly on the intervention, and no statistically significant interaction effects were found for any of the 3 HRQoL variables. In conclusion, the SPACE intervention had no impact on preschoolers’ HRQoL. Given the scarcity of research in this population, additional exploration is necessary to better understand the potential impact of physical activity participation on preschoolers’ HRQoL.

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