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Study protocol: mobile improvement of self-management ability through rural technology (mI SMART).

Mallow JA, Theeke LA, Long DM, Whetsel T, Theeke E, Mallow BK - Springerplus (2015)

Bottom Line: However, currently there is lack of studies that provide evidence of feasibility, acceptability, and effectiveness of mHealth initiatives on improved outcomes of care, a needed step to make the translation to implementation studies in healthcare systems.We anticipate high patient-provider satisfaction, enhanced patient-provider communication, and improved health related quality of life, adherence to treatment, and self-management ability.In addition, we hypothesize that patients who use mI SMART will demonstrate improved physical outcomes such as blood glucose, blood pressure, and weight.

View Article: PubMed Central - PubMed

Affiliation: West Virginia University Health Sciences Center, Mortantown, WV USA.

ABSTRACT

Background: There are 62 million Americans currently residing in rural areas who are more likely to have multiple chronic conditions and be economically disadvantaged, and in poor health, receive less recommended preventive services and attend fewer visits to health care providers. Recent advances in mobile healthcare (mHealth) offer a promising new approach to solving health disparities and improving chronic illness care. It is now possible and affordable to transmit health information, including values from glucometers, automated blood pressure monitors, and scales, through Bluetooth-enabled devices. Additionally, audio and video communications technologies can allow healthcare providers to conduct many parts of a physical exam remotely from varied settings. These technologies could remove geographical distance as a barrier to care and diminish the access to care issues faced by patients who live rurally. However, currently there is lack of studies that provide evidence of feasibility, acceptability, and effectiveness of mHealth initiatives on improved outcomes of care, a needed step to make the translation to implementation studies in healthcare systems. The purpose of this paper is to present the protocol for the first study of mI SMART (mobile Improvement of Self-Management Ability through Rural Technology), a new integrated mHealth intervention.

Methods: Our objective is to provide evidence of feasibility and acceptability for the use of mI SMART in an underserved population and establish evidence for the refinement of mI SMART. The proposed study will take place at Milan Puskar Health Right, a free primary care clinic in the state of West Virginia. The clinic provides health care at no cost to uninsured, low income; adults aged 18-64 living in West Virginia. We will enroll 30 participants into this feasibility study with plans of implementing a longitudinal randomized, comparative effectiveness design in the future. Data collection will include tracking of barriers and facilitators to using mI SMART on patient and provider feedback surveys, tracking of patient-provider communications, self-reports from patients on quality of life, adherence, and self-management ability, and capture of health record data on chronic illness measures.

Discussion: We expect that the mI SMART intervention, refined from participant and provider feedback, will be acceptable and feasible. We anticipate high patient-provider satisfaction, enhanced patient-provider communication, and improved health related quality of life, adherence to treatment, and self-management ability. In addition, we hypothesize that patients who use mI SMART will demonstrate improved physical outcomes such as blood glucose, blood pressure, and weight.

No MeSH data available.


Related in: MedlinePlus

West Virginia medically underserved areas.
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Fig1: West Virginia medically underserved areas.

Mentions: Of West Virginia’s 55 counties, 49 counties contain areas that are designated as medically underserved areas (purple) or medically underserved populations (green), as depicted in Fig. 1 (West Virginia Health Statistics Center 2013). Federally Qualified Health Centers (FQHC) provide care to 19.6 % of the population in West Virginia (DHHR November 2011). All persons regardless of ability to pay are able to receive care from FQHCs. The mission of FQHCs was originally meant to provide comprehensive health services to medically underserved populations to reduce the patient load on hospital emergency rooms. However, the state of West Virginia consistently ranks highest in the number of emergency room visits and preventable hospitalizations (United Health Foundation 2012). Uninsured people under age 65 averaged $1,397 in expenses for just one emergency room visit, which they paid out of pocket (Agency for Healthcare Research and Quality 2009). Additionally, even though West Virginia does have a system of free clinics, 17.7 % of the population in West Virginia reported that they could not seek medical care due to cost, which is higher than the national average of 14.6 % (Centers for Medicare and Medicaid Services 2008). Hidden costs associated with healthcare attendance include inability to quickly access care due to distance, lack of an interstate transportation system, lack of a personal automobile, lack of well-developed public transportation systems, and cost of transportation (Arcury and Gesler 2005 expert).Fig. 1


Study protocol: mobile improvement of self-management ability through rural technology (mI SMART).

Mallow JA, Theeke LA, Long DM, Whetsel T, Theeke E, Mallow BK - Springerplus (2015)

West Virginia medically underserved areas.
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4537468&req=5

Fig1: West Virginia medically underserved areas.
Mentions: Of West Virginia’s 55 counties, 49 counties contain areas that are designated as medically underserved areas (purple) or medically underserved populations (green), as depicted in Fig. 1 (West Virginia Health Statistics Center 2013). Federally Qualified Health Centers (FQHC) provide care to 19.6 % of the population in West Virginia (DHHR November 2011). All persons regardless of ability to pay are able to receive care from FQHCs. The mission of FQHCs was originally meant to provide comprehensive health services to medically underserved populations to reduce the patient load on hospital emergency rooms. However, the state of West Virginia consistently ranks highest in the number of emergency room visits and preventable hospitalizations (United Health Foundation 2012). Uninsured people under age 65 averaged $1,397 in expenses for just one emergency room visit, which they paid out of pocket (Agency for Healthcare Research and Quality 2009). Additionally, even though West Virginia does have a system of free clinics, 17.7 % of the population in West Virginia reported that they could not seek medical care due to cost, which is higher than the national average of 14.6 % (Centers for Medicare and Medicaid Services 2008). Hidden costs associated with healthcare attendance include inability to quickly access care due to distance, lack of an interstate transportation system, lack of a personal automobile, lack of well-developed public transportation systems, and cost of transportation (Arcury and Gesler 2005 expert).Fig. 1

Bottom Line: However, currently there is lack of studies that provide evidence of feasibility, acceptability, and effectiveness of mHealth initiatives on improved outcomes of care, a needed step to make the translation to implementation studies in healthcare systems.We anticipate high patient-provider satisfaction, enhanced patient-provider communication, and improved health related quality of life, adherence to treatment, and self-management ability.In addition, we hypothesize that patients who use mI SMART will demonstrate improved physical outcomes such as blood glucose, blood pressure, and weight.

View Article: PubMed Central - PubMed

Affiliation: West Virginia University Health Sciences Center, Mortantown, WV USA.

ABSTRACT

Background: There are 62 million Americans currently residing in rural areas who are more likely to have multiple chronic conditions and be economically disadvantaged, and in poor health, receive less recommended preventive services and attend fewer visits to health care providers. Recent advances in mobile healthcare (mHealth) offer a promising new approach to solving health disparities and improving chronic illness care. It is now possible and affordable to transmit health information, including values from glucometers, automated blood pressure monitors, and scales, through Bluetooth-enabled devices. Additionally, audio and video communications technologies can allow healthcare providers to conduct many parts of a physical exam remotely from varied settings. These technologies could remove geographical distance as a barrier to care and diminish the access to care issues faced by patients who live rurally. However, currently there is lack of studies that provide evidence of feasibility, acceptability, and effectiveness of mHealth initiatives on improved outcomes of care, a needed step to make the translation to implementation studies in healthcare systems. The purpose of this paper is to present the protocol for the first study of mI SMART (mobile Improvement of Self-Management Ability through Rural Technology), a new integrated mHealth intervention.

Methods: Our objective is to provide evidence of feasibility and acceptability for the use of mI SMART in an underserved population and establish evidence for the refinement of mI SMART. The proposed study will take place at Milan Puskar Health Right, a free primary care clinic in the state of West Virginia. The clinic provides health care at no cost to uninsured, low income; adults aged 18-64 living in West Virginia. We will enroll 30 participants into this feasibility study with plans of implementing a longitudinal randomized, comparative effectiveness design in the future. Data collection will include tracking of barriers and facilitators to using mI SMART on patient and provider feedback surveys, tracking of patient-provider communications, self-reports from patients on quality of life, adherence, and self-management ability, and capture of health record data on chronic illness measures.

Discussion: We expect that the mI SMART intervention, refined from participant and provider feedback, will be acceptable and feasible. We anticipate high patient-provider satisfaction, enhanced patient-provider communication, and improved health related quality of life, adherence to treatment, and self-management ability. In addition, we hypothesize that patients who use mI SMART will demonstrate improved physical outcomes such as blood glucose, blood pressure, and weight.

No MeSH data available.


Related in: MedlinePlus