scholarly journals Peer-led theoretically Desinged HIV/AIDS prevention intervention among students: a case of health belief model

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Hoda Joorbonyan ◽  
Mohtasham Ghaffari ◽  
Sakineh Rakhshanderou
Keyword(s):  
High Risk ◽  
Health Belief Model ◽  
Behavioral Intention ◽  
Self Efficacy ◽  
Intervention Group ◽  
Health Belief ◽  
Perceived Barriers ◽  
Control Group ◽  
Belief Model ◽  
Awareness Level

Abstract Background & aim HIV/AIDS is one of the most dangerous viruses known in the world. In addition, considering its fatality rate and high cost of care, it is a serious threat to the health and economy of social communities. Adolescents are one of the high-risk groups. One of the most effective ways to prevent this disease is to promote healthcare, raise awareness, and change health-related beliefs and attitudes. This study aims at determining the effect of peer education, based on the health belief model, on the preventative measures against AIDS adopted by girls. Methods & materials In this empirical-interventionist study two schools were randomly selected, one of which was considered as the intervention group and the other as the control group. The classes were also randomly selected and 80 students from each school took part in the project following the entry criterion. A questionnaire with acceptable validity and reliability was used to collect data. In this study a few bright students were chosen as peer educators after being trained. The intervention group (N = 80) received 4 sessions of 60-min education through training, lectures, question and answer, and group discussion, But the control group received no instruction. The posttest was administered two months after the treatment. The data was fed into the SPSS 16. Finally, T-test, Chi-Square, and ANCOVA were employed to analyze the data. Results The average scores obtained from the intervention group and the control group were not significantly different in terms of awareness level, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, perceived self-efficacy, behavioral intention, and behavior in baseline (P>0.05). Two months after the intervention there was a significant increase in the average scores of all the variables in the experimental group (P > 0.05). However, there was no significant change in the scores of the control group (P > 0.05). Conclusion Following a health belief model focusing on peer eduaction among high school girls, the intervention eduaction can affect awareness level, susceptibility, severity, benefits, perceived barriers, perceived self-efficacy, behavioral intention, and finally avoidance of high-risk behavior.

scholarly journals Peer-led Theoretically Desinged HIV/AIDS Prevention Intervention Among Students: A Case Of Health Belief Model

2021 ◽  
Author(s):  
Hoda Joorbonyan ◽  
Ghaffari Mohtasham ◽  
Rakhshanderou Sakineh
Keyword(s):  
High Risk ◽  
Health Belief Model ◽  
Behavioral Intention ◽  
Self Efficacy ◽  
Intervention Group ◽  
Health Belief ◽  
Perceived Barriers ◽  
Control Group ◽  
Belief Model ◽  
Awareness Level

Abstract Background & Aim: HIV/AIDS is one of the most dangerous viruses known in the world. In addition, considering its fatality rate and high cost of care, it is a serious threat to the health and economy of social communities. Adolescents are one of the high-risk groups. One of the most effective ways to prevent this disease is to promote healthcare, raise awareness, and change health-related beliefs and attitudes. This study aims at determining the effect of peer education, based on the health belief model, on the preventative measures against AIDS adopted by girls. Methods & Materials: In this empirical-interventionist study two schools were randomly selected, one of which was considered as the intervention group and the other as the control group. The classes were also randomly selected and 80 students from each school took part in the project following the entry criterion. A questionnaire with acceptable validity and reliability was used to collect data. In this study a few bright students were chosen as peer educators after being trained. The intervention group received 4 sessions of 60-minute education through training, lectures, question and answer, and group discussion. The posttest was administered two months after the treatment. The data was fed into the SPSS 16. Finally, T-test, Chi-Square, and ANCOVA were employed to analyze the data. 2 Results: The average scores obtained from the intervention group and the control group were not significantly different in terms of awareness level, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, perceived self-efficacy, behavioral intention, and pre-intervention behavior (P˃0.05). Two months after the intervention there was a significant increase in the average scores of all the variables in the experimental group (P>0.05). However, there was no significant change in the scores of the control group (P>0.05). Conclusion: Following a health belief model focusing on peer eduaction among high school girls, the intervention eduaction can affect awareness level, susceptibility, severity, benefits, perceived barriers, perceived self-efficacy, behavioral intention, and finally avoidance of high-risk behavior.

scholarly journals Determinants of Breast Self-Examination Practice among Women in Surabaya, Indonesia: An Application of the Health Belief Model

2019 ◽  
Author(s):  
Triana Kesuma Dewi ◽  
Karlijn Massar ◽  
Robert A.C. Ruiter ◽  
Tino Leonardi
Keyword(s):  
Breast Cancer ◽  
Health Belief Model ◽  
Self Efficacy ◽  
Health Belief ◽  
Perceived Barriers ◽  
Perceived Benefits ◽  
Breast Self Examination ◽  
Cues To Action ◽  
Belief Model ◽  
Self Examination

Background. Breast cancer has become one of the most prevalent causes of mortality among Indonesian women. Better prognosis of breast cancer will be achieved if it is diagnosed in an earlier stage, thus efforts to detect breast cancer earlier are important. Breast Self-Examination (BSE) is considered as an important first step to encourage women to actively be responsible for their own health, especially for women in developing countries with limited resources and access to other forms of preventive healthcare. The present study aimed to predict BSE behavior among women in Surabaya, Indonesia using the HBM. Methods. This investigation was a cross-sectional survey which was distributed among 1,967 women aged 20-60 years. The Indonesian version of Champion’s Health Belief Model Scale (I-CHBMS) was used to explain self-reported BSE practice. Logistic regression analysis was used to examine the association of HBM variables with BSE practice.Results Almost half of the sample (44.4%) had performed BSE. Further, the results indicated that the HBM variables were significantly associated with BSE practice. Specifically, higher perceived benefits and self-efficacy, lower perceived barriers and less cues to action were unique correlates of BSE behavior. The result also showed that perceived severity and susceptibility were not associated with BSE behavior. Conclusion. This study indicated that several HBM constructs significantly associated with BSE behavior among Indonesian women, suggesting that BSE health education programs should emphasize the perceived benefits of BSE, focus on increasing women’s self-efficacy to address and overcome perceived barriers in performing BSE, and help them in identifying personally relevant cues to action.

scholarly journals Applying the Health Belief Model in Explaining the Stages of Exercise Change in Older Adults

2016 ◽  
Vol 23 (4) ◽  
pp. 221-225 ◽  
Author(s):  
Krzysztof Sas-Nowosielski ◽  
Andrzej Hadzik ◽  
Joanna Górna ◽  
Małgorzata Grabara
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Health Belief Model ◽  
Self Efficacy ◽  
Sedentary Lifestyle ◽  
Health Belief ◽  
Health Behaviours ◽  
Perceived Barriers ◽  
Belief Model ◽  
The Health Belief Model

Abstract Introduction. The benefits of physical activity (PA) have been so well documented that there is no doubt about the significance of PA for personal and social health. Several theoretical models have been proposed with a view to understanding the phenomenon of PA and other health behaviours. The purpose of this study was to evaluate if and how the variables suggested in the Health Belief Model (HBM) determine physical activity stages of change in older adults. Material and methods. A total of 172 students of Universities of the Third Age aged 54 to 75 (mean = 62.89 ± 4.83) years agreed to participate in the study, filling out an anonymous survey measuring their stage of exercise change and determinants of health behaviours proposed by the HBM, including: perceived benefits of physical activity, perceived barriers to physical activity, perceived severity of diseases associated with sedentary lifestyle, perceived susceptibility to these diseases, and self-efficacy. Results. The results only partially support the hypothesis that the HBM predicts intentions and behaviours related to the physical activity of older adults. Only two variables were moderately-to-strongly related to stages of exercise change, namely perceived barriers and self-efficacy. Conclusion. Interventions aimed at informing older adults about the benefits of physical activity and the threats associated with sedentary lifestyle can be expected to have rather a weak influence on their readiness for physical activity.

scholarly journals The Effect of Educational Intervention on Safe and High-Risk Driving Behaviors in Taxi Drivers

2020 ◽  
Vol 24 (2) ◽  
Author(s):  
Asghar Razmara ◽  
Teamur Aghamolaei ◽  
Zahra Hosseini ◽  
Abdolhossein Madani ◽  
Shahram Zare
Keyword(s):  
High Risk ◽  
Health Belief Model ◽  
Intervention Group ◽  
Health Belief ◽  
Safe Driving ◽  
Taxi Drivers ◽  
Driving Behaviors ◽  
Belief Model ◽  
Risk Driving ◽  
The Health Belief Model

Background: High-risk driving behaviors is one of the leading causes of death and disability. Objectives: The aim of this study was to determine the effect of educational intervention on promoting safe-driving behaviors and reducing high risk-driving behaviors in taxi drivers based on the health belief model and planned behavior theory. Methods: A quasi-experimental study of interventional and control drivers (n = 40) selected by a cluster sampling method was conducted. The participants were selected from taxi stations. The intervention group was divided into 4 groups, including 10 people. The contents of the training program were based on driving laws, avoiding high-risk behaviors, and advising on safe driving behaviors. The driving behaviors were measured at baseline and 3-month post-intervention. Constructs of the health belief model and theory of planned behavior were used as an interventional program framework. Independent t-test and Paired t-test were used to compare the scores between intervention and control drivers and the intervention group before and after the intervention at each of the variables, respectively. Results: Three months post-intervention, the scores of safe driving behaviors in the intervention group were higher than the control group, and high-risk driving behaviors in the intervention group were less than the control group. After the intervention, a significant difference was observed in the mean scores of perceived barriers, self-efficacy, cues to action, attitude, subjective norms, and perceived behavioral control between two groups (P < 0.05). Conclusions: Educational intervention within the framework of the combined constructs of the health belief model and theory of planned behavior can reduce high-risk driving behaviors and promote safe driving behaviors in taxi drivers.

scholarly journals Determinants of breast self-examination practice among women in Surabaya, Indonesia: an application of the health belief model

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Triana Kesuma Dewi ◽  
Karlijn Massar ◽  
Robert A. C. Ruiter ◽  
Tino Leonardi
Keyword(s):  
Breast Cancer ◽  
Health Belief Model ◽  
Self Efficacy ◽  
Health Belief ◽  
Perceived Barriers ◽  
Perceived Benefits ◽  
Breast Self Examination ◽  
Belief Model ◽  
Self Examination ◽  
The Health Belief Model

Abstract Background Breast cancer has become one of the most common causes of mortality among Indonesian women. Many women in Indonesia present with late-stage breast cancer, negatively affecting prognosis and treatment outcomes. Better prognosis of breast cancer will be achieved if it is diagnosed in an earlier stage, thus efforts to detect breast cancer earlier are important. Breast Self-Examination (BSE) is considered as an important first step to encourage women to actively be responsible for their own health, especially for women in low-and middle-income countries with limited resources and access to other forms of preventive healthcare (e.g., screening programs). The present study aimed to predict BSE practice among women in Surabaya, Indonesia using the Health Belief Model (HBM). Methods This investigation was a cross-sectional survey which was distributed among 1967 women aged 20–60 years. The Indonesian version of Champion’s Health Belief Model Scale (I-CHBMS) was used to explain self-reported BSE practice. Logistic regression analysis was used to examine the association of HBM variables with BSE practice. Results 44.4% of the respondents indicated they had performed BSE. Further, the results indicated that the HBM variables were significantly associated with BSE practice. Specifically, higher perceived benefits and self-efficacy, lower perceived barriers and less cues to action were unique correlates of BSE practice. The result also showed that perceived severity and susceptibility were not associated with BSE practice. Conclusion This study indicated that several HBM constructs significantly associated with BSE practice among Indonesian women, suggesting that BSE health education programs should emphasize the perceived benefits of BSE, focus on increasing women’s self-efficacy to address and overcome perceived barriers in performing BSE, and help them in identifying personally relevant cues to action.

scholarly journals Safe driving behaviors in taxi drivers: A predictive cross-sectional study based on the health belief model

2020 ◽  
Author(s):  
Sakineh Dadipoor ◽  
Vahid Ranaei ◽  
Mohtasham Ghaffari ◽  
Sakineh Rakhshanderou ◽  
Ali Safari-Moradabadi
Keyword(s):  
Health Belief Model ◽  
Self Efficacy ◽  
Pearson Correlation ◽  
Health Belief ◽  
Perceived Barriers ◽  
Safe Driving ◽  
Perceived Severity ◽  
Taxi Drivers ◽  
Driving Behaviors ◽  
Belief Model

Abstract Background: The purpose of this study was to predict safe driving behaviors among taxi drivers of Tehran based on the constructs of health belief model. Methods: This descriptive-analytical study was performed on 450 taxi drivers in Tehran using multi-stage sampling. Data were analyzed through SPSS software version 18 using Pearson correlation coefficient and multivariate regression analysis. The P <0.05 was considered statistically significant. Results: Among the constructs of health belief model, perceived severity, perceived benefits and self-efficacy, had significant and direct relationship and perceived barriers had a significant and reverse relationship with safe driving behaviors. According to the results, the constructs of health belief model predicted 17.3% of safe driving behaviors. Self-efficacy was the strongest determinant of safety behaviors (0.362 CI 0.098-0.625). Conclusions: Increasing self-efficacy, reducing perceived barriers and highlighting benefits for the purpose of accepting safe behaviors can be considered as a principle in driving education and training. Also, increasing the perceived severity of adverse outcomes of RTAs and the susceptibility to these outcomes will lead to higher levels of safe driving behaviors.

scholarly journals Dampak promosi kesehatan Kawasan Tanpa Rokok di Bandara Sultan

2019 ◽  
Vol 49 (1) ◽  
pp. 24-33
Author(s):  
Dwi Indah Lestari
Keyword(s):  
Health Belief Model ◽  
Self Efficacy ◽  
Health Belief ◽  
Perceived Barriers ◽  
Perceived Susceptibility ◽  
Purposive Sampling ◽  
Depth Interview ◽  
Perceived Benefit ◽  
Perceived Seriousness ◽  
Belief Model

Efek buruk asap rokok lebih besar bagi perokok pasif dibandingkan perokok aktif. Oleh karena itu diperlukan langkah-langkah pengamanan rokok bagi kesehatan, diantaranya melalui penetapan Kawasan Tanpa Rokok. Bandara Sultan Mahmud Badaruddin II adalah bandara internasional dan salah satu tempat Kawasan Tanpa Rokok yang memiliki sejumlah promosi kesehatan tentang Kawasan Tanpa Rokok. Penelitian ini bertujuan Tujuan penelitian ini adalah mendeskripsikan dampak promosi kesehatan kawasan tanpa rokok di Bandara Sultan Mahmud Badaruddin II. Penelitian ini merupakan penelitian kualitatif dengan metode in-depth interview (wawancara mendalam) dan observasi. Informan penelitian ini sebanyak 7 orang ditentukan secara purposive sampling. Analisis dampak promosi kesehatan menggunakan konsep Health-Belief Model (perceived susceptibility, perceived seriousness/severity, perceived benefit, perceived barriers, cues to action, self-efficacy). Penelitian ini dilakukan dengan metode in-depth interview (wawancara mendalam) dan observasi. Analisis dampak promosi kesehatan menggunakan konsep Health-Belief Model. Terdapat dampak dari promosi kesehatan kawasan tanpa rokok di Bandara Sultan Mahmud Badaruddin II pada pekerja dan pengunjung. Persepsi kerentanan pada pekerja yaitu merasa rentan terkena sanksi KTR. Persepsi kerentanan pada pengunjung yaitu merasa rentan membahayakan kesehatan orang lain dan lingkungan. Persepsi keseriusan/keparahan pada pekerja dan pengunjung yaitu merasa berbahaya kebakaran dan mengganggu penerbangan. Persepsi manfaat pada pekerja yaitu keselamatan bandara dan penerbangan. Persepsi manfaat pada pengunjung yaitu dapat terhindar dari asap rokok. Persepsi hambatan pada pekerja dan pengunjung yaitu kecanduan, kurang kesadaran, dan kurang pemahaman mengenai KTR. Pemicu untuk bertindak pada pekerja dan pengunjung adalah teguran dari petugas. Kemampuan diri pada pekerja dan pengunjung karena memahami peraturan dan menaatinya.

scholarly journals An mHealth Assistive System “MyLung” to Empower Patients with Chronic Obstructive Pulmonary Disease: Design Science Research (Preprint)

2018 ◽  
Author(s):  
Riad Alharbey ◽  
Samir Chatterjee
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Behavioral Intention ◽  
Self Efficacy ◽  
Care Management ◽  
Intervention Group ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Awareness Level

BACKGROUND Chronic obstructive pulmonary disease (COPD) comprises a group of progressive diseases that deteriorate lung functions. When patients cannot breathe, nothing else in their lives matter. Breathlessness has negative implications on patients’ lives, which leads to physical and psychological limitations. Moreover, the lack of relevant and updated information about the causes and consequences of the disease can exacerbate the problems of health literacy, information accessibility, and medical adherence. OBJECTIVE The objective of this study is to design an innovative mobile health (mHealth) app system called “MyLung” that provides complete solutions in order to increase self-awareness and promote better self-care management. This system, an information technology artifact, includes three novel integrative modules: education, risk reduction, and monitoring. METHODS The utility and effectiveness of the assistive mobile-based technology were evaluated using a mixed-methods approach. The study combined quantitative and qualitative research methods to thoroughly understand how the assistive mobile-based technology can influence patients’ behavioral intention to change their lifestyle. Thirty patients were categorized into two groups (intervention group and control group). RESULTS The results from the quantitative analysis led to four follow-up interviews in the qualitative study. The results of the quantitative study provided significant evidence to show that the design of MyLung leads to a change in the awareness level, self-efficacy, and behavioral intention for patients with COPD. The t tests revealed a significant difference before and after using the mobile-based app with regard to the awareness level (mean 3.28 vs 4.56; t10=6.062; P<.001), self-efficacy (mean 3.11 vs 5.56; t10=2.96; P=.01), and behavioral intention (mean 2.91 vs 4.55; t10=3.212; P=.009). Independent sample t tests revealed significant differences between the intervention group and the control group in terms of the awareness level (mean 4.56 vs 3.31; t19=4.80; P<.001) and self-efficacy (mean 5.56 vs 3.66; t19=2.8; P<.01). Integration of findings from quantitative and qualitative studies reveled the impact of the design in a comprehensive manner. These inferences are referred to as “meta-inferences” in this study. CONCLUSIONS We designed an innovative assistive mobile-based technology to empower patients with COPD, which helped increase awareness and engage patients in self-care management activities. The assistive technology aims to inform patients about the risk factors of COPD and to improve access to relevant information. Meta-inferences that emerge from the research outputs contribute to research into chronic management information systems by helping us gain a more complete understanding of the potential impacts of this proposed mobile-based design on patients with chronic disease.

scholarly journals Health Belief Model Perspective on the Control of COVID-19 Vaccine Hesitancy and the Promotion of Vaccination in China: Web-Based Cross-sectional Study (Preprint)

2021 ◽  
Author(s):  
Hao Chen ◽  
Xiaomei Li ◽  
Junling Gao ◽  
Xiaoxi Liu ◽  
Yimeng Mao ◽  
...  
Keyword(s):  
Health Belief Model ◽  
Self Efficacy ◽  
Health Belief ◽  
Vaccination Rate ◽  
Mediating Effect ◽  
Perceived Barriers ◽  
Vaccine Hesitancy ◽  
Perceived Benefits ◽  
Convenience Sample ◽  
Belief Model

BACKGROUND The control of vaccine hesitancy and the promotion of vaccination are key protective measures against COVID-19. OBJECTIVE This study assesses the prevalence of vaccine hesitancy and the vaccination rate and examines the association between factors of the health belief model (HBM) and vaccination. METHODS A convenience sample of 2531 valid participants from 31 provinces and autonomous regions of mainland China were enrolled in this online survey study from January 1 to 24, 2021. Multivariable logistic regression was used to identify the associations of the vaccination rate and HBM factors with the prevalence of vaccine hesitancy after other covariates were controlled. RESULTS The prevalence of vaccine hesitancy was 44.3% (95% CI 42.3%-46.2%), and the vaccination rate was 10.4% (9.2%-11.6%). The factors that directly promoted vaccination behavior were a lack of vaccine hesitancy (odds ratio [OR] 7.75, 95% CI 5.03-11.93), agreement with recommendations from friends or family for vaccination (OR 3.11, 95% CI 1.75-5.52), and absence of perceived barriers to COVID-19 vaccination (OR 0.51, 95% CI 0.35-0.75). The factors that were directly associated with a higher vaccine hesitancy rate were a high level of perceived barriers (OR 1.63, 95% CI 1.36-1.95) and perceived benefits (OR 0.51, 95% CI 0.32-0.79). A mediating effect of self-efficacy, influenced by perceived barriers (standardized structure coefficient [SSC]=−0.71, <i>P</i>&lt;.001), perceived benefits (SSC=0.58, <i>P</i>&lt;.001), agreement with recommendations from authorities (SSC=0.27, <i>P</i>&lt;.001), and agreement with recommendations from friends or family (SSC=0.31, <i>P</i>&lt;.001), was negatively associated with vaccination (SSC=−0.45, <i>P</i>&lt;.001) via vaccine hesitancy (SSC=−0.32, <i>P</i>&lt;.001). CONCLUSIONS It may be possible to increase the vaccination rate by reducing vaccine hesitancy and perceived barriers to vaccination and by encouraging volunteers to advocate for vaccination to their friends and family members. It is also important to reduce vaccine hesitancy by enhancing self-efficacy for vaccination, due to its crucial mediating function.

scholarly journals MyLung: A mHealth Assistive System to Empower Patients with COPD (Preprint)

2020 ◽  
Author(s):  
Abc Xyz
Keyword(s):  
Behavioral Intention ◽  
Self Efficacy ◽  
Care Management ◽  
Intervention Group ◽  
Self Care ◽  
Control Group ◽  
Systems Research ◽  
Significant Difference ◽  
The Impact ◽  
Awareness Level

BACKGROUND Chronic Obstructive Pulmonary Disease (COPD) is one of those progressive diseases that deteriorate lung functions. When patients cannot breathe, nothing else in their lives matter. The breathlessness has negative implications on patients’ lives that lead to physical and psychological limitations. The physical limitations impede daily life activities that are essential for patients with COPD. Psychological limitations are manifested in anxiety that results from the emotional response to breathlessness. Because patients with COPD are always overwhelmed by anxiety and depression, they are less motivated to engage in self-care and education intervention. Moreover, the lack of relevant and updated information about the causes and consequences of the disease can exacerbate the problems of health literacy, information accessibility, and medical adherence. OBJECTIVE The objective of this study is to design an innovative mHealth app system called “MyLung” that provides a complete solution to increase self-awareness and to promote better self-care management. This IT artifact includes three integrative modules that are novel: education, risk reduction, and monitoring. METHODS The utility and effectiveness of the assistive mobile-based technology are evaluated using mixed methods approach. The study combines quantitative and qualitative research methods to thoroughly understand how the assistive mobile-based technology can influence patients’ behavioral intention to change their lifestyle. Thirty patients were assigned in two groups (intervention group and control group). The results from the quantitative analysis introduced several follow-up interviews using a qualitative study RESULTS The results of the quantitative study provide significant evidence that the design of MyLung leads to change in awareness level, self-efficacy and behavioral intention for patients with COPD. T- tests reveal significant difference before and after using mobile based app for awareness level (M = 3.28 versus 4.56, t(10) = 6.062, p < 0.001), self-efficacy (M = 3.11 versus 5.56, t(10) = 2.96, p = 0.014) and behavioral intention (M = 2.91versus 4.55, t(10) = 3.212, p = 0.009). In the same vein, independent sample t-tests reveal significant difference between groups in awareness level (M = 4.56 versus 3.31, t(19) = 4.80, p < 0.001) and self- efficacy (M = 5.56 versus 3.66, t(19) = 2.8, p < 0.012). Integrating findings from quantitative and qualitative strands introduces inferences that describe the impact of the design in a comprehensive view. These inferences are referred in this study as “meta-inferences”. CONCLUSIONS The objective of this research is to empower patients with COPD with assistive mobile-based technology that helps increase awareness levels and to engage patients in self-care management activities. The assistive technology aims to inform patients about the risk factors of COPD, and to improve access to relevant information. Meta-inferences that are emerged from the research outputs contribute to chronic management information systems research by helping us gain more complete understanding of the potential impacts of this proposed mobile-based design on patients with chronic disease.

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