Carolyn Lauckner

Diabetes Management via Mobile Phones: A Systematic Review

BACKGROUND This study sought to understand the most common uses and functions of mobile phones in monitoring and managing diabetes, their potential role in a clinical setting, and the current state of research in this area. METHODS We identified peer-reviewed articles published between 2000 and 2010. Twenty-one articles were analyzed for this systematic literature review. RESULTS The majority of studies examined the use of mobile phones from the patients perspective. Subjects with type 1 diabetes were enrolled exclusively in over 50% of the studies. Seventy-one percent of the studies used a study-specific application, which had supplemental features in addition to text messaging. The outcomes assessed varied considerably across studies, but some positive trends were noted, such as improved self-efficacy, hemoglobin A1c, and self-management behaviors. CONCLUSIONS The studies evaluated showed promise in using mobile phones to help people with diabetes manage their condition effectively. However, many of these studies lacked sufficient sample sizes or intervention lengths to determine whether the results might be clinically or statistically significant. Future research should examine other key issues, such as provider perceptions, integration into a healthcare practice, and cost, which would provide important insight into the use of mobile phones for chronic disease management.

Facebooking for health: An examination into the solicitation and effects of health-related social support on social networking sites

Abstract The current study investigates people’s use of social networking sites for health purposes and its impact on their perception of social support and their health self-efficacy. A structural model was fitted to test hypothesized relationships between having a health concern, seeking online health information, seeking health-related social support on Facebook, perceived social support from Facebook friends, and health-related self-efficacy. The study also looks at the relative significance of social support dimensions including: emotional, informational, tangible, and esteem dimensions. An analysis of 291 respondents revealed a positive relationship between having health concerns and seeking health-related social support. Seeking support was significantly associated with all four social support dimensions. Among the four support dimensions, emotional support was the only significant predictor of health self-efficacy. Also, emotional support was the dimension that was most prevalent in Facebook contexts. Health information seeking was also positively associated with health self-efficacy but was not significantly related to having a health concern.

The presentation of health-related search results and its impact on negative emotional outcomes

Searching for health information online has become increasingly common, yet few studies have examined potential negative emotional effects of online health information search. We present results from an experiment manipulating the presentation of search results for common symptoms, which shows that the frequency and placement of serious illness mentions within results can influence perceptions of symptom severity and susceptibility of having the serious illness, respectively. The increase in severity and susceptibility can then lead to higher levels of negative emotional outcomes experienced--including feeling overwhelmed and frightened. Interestingly, health literacy can help reduce perceived symptom severity, and high online health experience actually increases the likelihood that individuals use a frequency-based heuristic. Technological implications and directions for future research are discussed.

An Initial Investigation Into Naturally Occurring Loss- and Gain-Framed Memorable Breast Cancer Messages

Memorable message research examines interpersonal messages “ … remembered for extremely long periods of time and which people perceive as a major influence on the course of their lives” (Knapp, Stohl, & Reardon, 1981, p. 27). They can also guide actions, such as health behaviors. This exploratory research examined self-reported memorable messages about breast cancer to determine if they were framed, emphasizing either the benefits (gain-framed) or the costs (loss-framed) of a behavior. About one-fourth of the messages were framed, with most being gain-framed. The messages tended to emphasize early detection actions. Study limitations and implications for future research are discussed.

The Differential Effects of Social Media Sites for Promoting Cancer Risk Reduction

Social media are potentially valuable tools for disseminating cancer education messages, but the differential effects of various sites on persuasive outcomes are unknown. In an effort to inform future health promotion, this research tested the effects of Facebook, YouTube, Twitter, and blogs for delivering a cancer risk reduction message. Using an experimental design, participants were randomly placed in several conditions that delivered the same message but with different forms of social media. Effects on comprehension and attitudes were examined, as they are important variables in the behavior change process. YouTube led to higher comprehension and stronger attitudes toward cancer risk reduction than Twitter, but there were no differences between other sites. Additionally, YouTube led to stronger attitudes toward cancer risk reduction as compared to Facebook, but not any other sites. These results demonstrate that, even if the message is kept constant, the form of social media used to deliver content can have an effect on persuasive outcomes. More research is needed to determine the mechanisms behind the differences found, however. Altogether, this line of research is valuable for any individuals seeking to use social media for health promotion purposes and could have direct implications for the development of cancer risk reduction campaigns.

Tools for assessing the quality and accessibility of online health information: initial testing among breast cancer websites

Health websites are used frequently, but there are many concerns about their value as information sources. Additionally, there are numerous personal barriers that prevent individuals from wholly benefitting from them. In order to assess the quality of health websites and their accessibility to users, we created tools based on previous research that examine design aspects, information validity, motivational health content and literacy content. To test these tools, we examined 155 breast cancer websites and created scores for each assessment tool to describe the percent of constructs on the average website. Results demonstrated that websites performed best on the design tool followed by the information validity, motivational health content and literacy assessment tools. The average website contained the majority of the design and information validity constructs, but only about a third of the motivational health or literacy constructs. Multiple items from the motivational health content and literacy assessment tools were not found on any of the websites, and many were only represented on a handful of sites. Overall, the assessment tools were useful in evaluating the quality of websites, and could serve as valuable resources for health website developers in the future.

The State and Sustainability of Telepsychiatry Programs

Telepsychiatry, or the provision of psychiatric care across a distance using communication technologies, has become widespread and has been used successfully for treating a variety of mental illnesses. Little is known, however, about the sustainability of telepsychiatry programs and their long-term success. The goal of this study was to determine current trends in telepsychiatry by completing an extensive literature review and to follow-up with the authors of telepsychiatry research to examine the current status of their programs and success factors or barriers associated with their experiences. Results indicated that modern telepsychiatry programs often target veteran/military or child populations and that many rely on either federal or internal funding. Interestingly, several researchers indicated that they wished to improve current funding mechanisms, while others wished for improvements in the technology used. Implications of these findings for behavioral health researchers are discussed, along with suggestions for improving future telepsychiatry programs.

The emotions and action tendencies associated with viewing online cancer information among patients’ loved ones

Loved ones of cancer patients are vulnerable, often reporting psychological distress and inadequate information provision. This research examined the use and emotional and behavioral effects of online cancer information. Compassion and fear were the strongest emotions elicited by online content, and respondents reported several cognitive, communicative, and helping behaviors. Multiple relationships between emotions and behaviors were found, including between hope and helping behaviors, anger and problem-solving, fear and seeking comfort, and sadness and a decreased likelihood of engaging in cancer prevention and detection. This study extends research on emotions and action tendencies and provides guidance for developing future online resources.

The Effects of Viewing and Preferences for Online Cancer Information Among Patients' Loved Ones.

Emotional and psychological distress is common among loved ones of cancer patients, who sometimes report more severe mental health issues than the patients themselves. In addition, many loved ones feel as though their information needs are not being met, which can lead them to seek out additional information online. This survey research examined the experiences of cancer patients’ loved ones in viewing online content about the disease and the emotional outcomes of such browsing sessions. Participants (N = 191) were recruited from cancer- and caregiver-related nonprofits and online discussion boards. Results indicated that patients’ loved ones were active users of online cancer Web sites. They primarily viewed and expressed a desire for information-based, rather than support-based, content. Many individuals desired in-depth treatment information, and those who viewed it had significantly more hope. Interestingly, multiple regression analysis revealed that viewing user-generated content was associated only with negative emotions, illustrating the potential dangers of social media spaces. Overall, this study shows the need for supporting patients’ loved ones during their almost inevitable viewings of online cancer information. More research is needed in order to determine the best methods of mitigating potential negative effects of cancer Web sites and developing a useful online resource for this population.

When technology alone is not enough: A discussion of a struggling telepsychiatry project and lessons from model programs

Telemedicine programs, though popular and increasingly effective, can sometimes fail with little indication as to why they did not succeed. This study, in an effort to investigate a failed telepsychiatry program and explore the impact of technology, conducted a series of interviews with project staff and other individuals participating in telepsychiatry across the country. Results indicated that barriers related to technology were not a key factor in terms of failure or success. Instead, community, patient-based, and study-specific barriers were the most commonly cited issues that inhibited study recruitment and enrollment. Based on these findings, a series of recommendations are put forth for utilizing technology to address common barriers and increase the likelihood of success in telepsychiatry.