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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

Population density of West Virginia.
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Fig3: Population density of West Virginia.

Mentions: Usage of technology in Rural America Mobile health (mHealth) is an emerging field that has been defined as “medical and public health practice supported by mobile devices, such as mobile phones, patient monitoring devices, personal digital assistants, and other wireless devices”(Cipresso et al. 2012). In the United States, there is widespread use of mobile devices and access to broadband internet service is improving (Smith 2010). Per Fig. 2, 3G service is available and reliable in the most densely populated areas of West Virginia. Much of the area where 3G service is not reliable consists of National Forest and parks (Fig. 3). Still, many of these areas have access to 1G and wired connections that could allow participation in mHealth interventions. It has been reported that even in the most rural areas of West Virginia, 77 % of adults have a cell phone (Zickuhr 2013). Currently, 88 % of American adults have a cell phone, 57 % have a laptop, and 38 % own an e-book reader or have a tablet computer. Six in ten adults (63 %) go online wirelessly with one of these devices (Zickuhr 2013). Although many technology-driven interventions has been found to improve outcomes, be cost effective, and culturally relevant (Ahern et al. 2011; Arsand et al. 2008; Ãrsand et al. 2008; Basoglu et al. 2012; Earle et al. 2010; Effken and Abbott 2009; Faridi et al. 2008; Istepanian et al. 2009; Jae-Hyoung et al. 2009; Logan et al. 2007; Lyles et al. 2011; Quinn et al. 2009; Rabin and Bock 2011; Turner et al. 2009; Yoo et al. 2009; Zolfaghari et al. 2009; Welch et al. 2015), no fully integrated systematic mHealth approach for delivery of healthcare at a distance has been studied or reported. Further, a recent systematic review of health information technology reports that continues to be a lack of evidence about the implementation and context of technology based projects (Jones et al. 2014).Fig. 2


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)

Population density of West Virginia.
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig3: Population density of West Virginia.
Mentions: Usage of technology in Rural America Mobile health (mHealth) is an emerging field that has been defined as “medical and public health practice supported by mobile devices, such as mobile phones, patient monitoring devices, personal digital assistants, and other wireless devices”(Cipresso et al. 2012). In the United States, there is widespread use of mobile devices and access to broadband internet service is improving (Smith 2010). Per Fig. 2, 3G service is available and reliable in the most densely populated areas of West Virginia. Much of the area where 3G service is not reliable consists of National Forest and parks (Fig. 3). Still, many of these areas have access to 1G and wired connections that could allow participation in mHealth interventions. It has been reported that even in the most rural areas of West Virginia, 77 % of adults have a cell phone (Zickuhr 2013). Currently, 88 % of American adults have a cell phone, 57 % have a laptop, and 38 % own an e-book reader or have a tablet computer. Six in ten adults (63 %) go online wirelessly with one of these devices (Zickuhr 2013). Although many technology-driven interventions has been found to improve outcomes, be cost effective, and culturally relevant (Ahern et al. 2011; Arsand et al. 2008; Ãrsand et al. 2008; Basoglu et al. 2012; Earle et al. 2010; Effken and Abbott 2009; Faridi et al. 2008; Istepanian et al. 2009; Jae-Hyoung et al. 2009; Logan et al. 2007; Lyles et al. 2011; Quinn et al. 2009; Rabin and Bock 2011; Turner et al. 2009; Yoo et al. 2009; Zolfaghari et al. 2009; Welch et al. 2015), no fully integrated systematic mHealth approach for delivery of healthcare at a distance has been studied or reported. Further, a recent systematic review of health information technology reports that continues to be a lack of evidence about the implementation and context of technology based projects (Jones et al. 2014).Fig. 2

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