Hannah E. Payne

Behavioral Functionality of Mobile Apps in Health Interventions: A Systematic Review of the Literature

Background Several thousand mobile phone apps are available to download to mobile phones for health and fitness. Mobile phones may provide a unique means of administering health interventions to populations. Objective The purpose of this systematic review was to systematically search and describe the literature on mobile apps used in health behavior interventions, describe the behavioral features and focus of health apps, and to evaluate the potential of apps to disseminate health behavior interventions. Methods We conducted a review of the literature in September 2014 using key search terms in several relevant scientific journal databases. Only English articles pertaining to health interventions using mobile phone apps were included in the final sample. Results The 24 studies identified for this review were primarily feasibility and pilot studies of mobile apps with small sample sizes. All studies were informed by behavioral theories or strategies, with self-monitoring as the most common construct. Acceptability of mobile phone apps was high among mobile phone users. Conclusions The lack of large sample studies using mobile phone apps may signal a need for additional studies on the potential use of mobile apps to assist individuals in changing their health behaviors. Of these studies, there is early evidence that apps are well received by users. Based on available research, mobile apps may be considered a feasible and acceptable means of administering health interventions, but a greater number of studies and more rigorous research and evaluations are needed to determine efficacy and establish evidence for best practices.

The Laugh Model: Reframing and Rebranding Public Health Through Social Media.

OBJECTIVES We examined the use of low-cost social media platforms in communicating public health messages and outline the laugh model, a framework through which public health organizations can reach and engage communities. METHODS In August 2014, we developed an online campaign (Web site and social media) to help promote healthy family meals in Utah in conjunction with the state and local health departments. RESULTS By the end of September 2014, a total of 3641 individuals had visited the Utahfamilymeals.org Web site. Facebook ads reached a total of 29 078 people, and 56 900 people were reached through Twitter ads. The per-person price of the campaign was 0.2 cents, and the total estimated target population reach was between 10% and 12%. CONCLUSIONS There are 3 key takeaways from our campaign: use of empowering and engaging techniques may be more effective than use of educational techniques; use of social media Web sites and online marketing tactics can enhance collaboration, interdisciplinary strategies, and campaign effectiveness; and use of social media as a communication platform is often preferable to use of mass media in terms of cost-effectiveness, more precise evaluations of campaign success, and increased sustainability.

Health Behavior Theory in Popular Calorie Counting Apps: A Content Analysis

Background Although the Health & Fitness category of the Apple App Store features hundreds of calorie counting apps, the extent to which popular calorie counting apps include health behavior theory is unknown. Objective This study evaluates the presence of health behavior theory in calorie counting apps. Methods Data for this study came from an extensive content analysis of the 10 most popular calorie counting apps in the Health & Fitness category of the Apple App Store. Results Each app was given a theory score to reflect the extent to which health behavior theory was integrated into the app. The highest possible score was 60. Out of the 10 apps evaluated, My Diet Coach obtained the highest theory score of 15. MapMyFitness and Yumget received the lowest scores of 0. The average theory score among the apps was 5.6. Conclusions Most of the calorie counting apps in the sample contained minimal health behavior theory.

Identifying and Reducing Disparities in Mental Health Outcomes Among American Indians and Alaskan Natives Using Public Health, Mental Healthcare and Legal Perspectives

The purpose of this paper was to investigate disparities in mental healthcare delivery in American Indian/Alaska Native populations from three perspectives: public health, legal policy and mental healthcare and provide evidence-based recommendations toward reducing those disparities. Data on mental health funding to tribes were obtained from the Substance Abuse and Mental Health Services Administration. As a result of analysis of these data, vital statistics and current literature, we propose three recommendations to reduce mental health disparities. First, where possible, increase mental health funding opportunities for federally-recognized tribes. Second, model funding practices on principles of tribal self-determination. Finally, support diverse interventions that are culturally-based and culturally-appropriate.

The Public Health Innovation Model: Merging Private Sector Processes with Public Health Strengths

Public health enjoyed a number of successes over the twentieth century. However, public health agencies have arguably been ill equipped to sustain these successes and address the complex threats we face today, including morbidity and mortality associated with persistent chronic diseases and emerging infectious diseases, in the context of flat funding and new and changing health care legislation. Transformational leaders, who are not afraid of taking risks to develop innovative approaches to combat present-day threats, are needed within public health agencies. We propose the Public Health Innovation Model (PHIM) as a tool for public health leaders who wish to integrate innovation into public health practice. This model merges traditional public health program planning models with innovation principles adapted from the private sector, including design thinking, seeking funding from private sector entities, and more strongly emphasizing program outcomes. We also discuss principles that leaders should consider adopting when transitioning to the PHIM, including cross-collaboration, community buy-in, human-centered assessment, autonomy and creativity, rapid experimentation and prototyping, and accountability to outcomes.

Health Behavior Change Theories in Physical Activity Pins on Pinterest: A Content Analysis

Background: Too few adults in developed countries get sufficient daily physical activity, which contributes to the burden of chronic disease. Social media sites may be effective methods of promoting health behavior change, especially when elements of health behavior theory (HBT) are incorporated. However, no research to date has specifically assessed the integration of HBT in physical activity-related pins on Pinterest. Purpose: A content analysis was conducted to assess the level of HBT in physical activity-related pins on Pinterest. Methods: A coding rubric was used to code a total of 461 physical activity-related pins for the presence of HBT (Theory of Planned Behavior, Social Cognitive Theory, and Health Belief Model) constructs. A total theory score was computed to provide a global assessment of theory integration. Pin characteristics were also analyzed using descriptive statistics. Adjusted linear regression analysis identified characteristics of pins related to inclusion of HBT in pins. Results: The average total HBT score was 2.35 out of a possible 9. Compared to private individuals, pins produced by organizations integrated significantly more HBT constructs (mean 2.23 vs. 2.01; p=.005). Other factors such as targeting the whole body, and exercise not requiring equipment also had high integration of HBT. The HBT construct ‘outcome expectations’ appeared most often in pins. Discussion: Pinterest pins can be used for health promotion among its users with the integration of HBT in the pins. Select pin characteristics are predictive of theory integration. The average total HBT score of 2.35 in all of the pins studied suggests that physical activity pins are lacking adequate levels of HBT. Conclusion: Pinterest is an inexpensive, user-friendly platform where health educators can easily generate theory-based pins that may influence physical activityrelated behaviors. Pinterest pins could also be used to disseminate information regarding physical activity to all its users with very low costs. Correspondence to: Samuel Patha, Department of Health Science, Brigham Young University, USA, Tel: 808-492-4499; E-mail: ajaypatha@gmail.com

Predictors of Peer Victimization in Peruvian Adolescents

Background: While bullying is recognized as a major public health concern worldwide, little research has been conducted on prevalence and predictors of bullying in Latin American countries such as Peru. Considering the negative effects that may be experienced by bully victims, including poor academic performance, psychological distress and in extreme cases suicide, identifying the factors associated with peer victimization is important to effectively addressing peer bullying. The purpose of this study was to estimate the prevalence of peer victimization in a sample of high school students in Cusco, Peru and to explore the relationship between victimization and potential correlating factors. Methods: A cross-sectional study of 949 high school aged adolescents from Cusco, Peru was undertaken. Adolescents from Cusco high schools were recruited and required to obtain parental consent to participate. The final sample of students completed a survey to answer questions about demographics, bullying, their parents’ parenting behaviors, the status of their home internet connection, and academic performance. Chi-square tests and adjusted logistic regression analysis were calculated using Stata version 12.1 and were used to assess potential risk factors associated with being bullied among boys and girls. Results: Over 20% of the sample reported being mistreated or bullied by peers. More boys than girls reported being bullied (28.5% vs. 19.5%; p = 0.002). Girls whose parents engaged in more positive parenting behaviors were less likely to be bullied, while having a home Internet connection and spending more than 60 minutes on social media during the previous day were associated with an increased risk of being bullied. Among boys, no variables were significantly associated with being bullied. Conclusions: Health practitioners may want to design bullying interventions that differ for boys and girls. Interventions for girls could benefit from increased parental involvement in particular. The association between time spent on social media and bullying among girls could also be investigated. Further research is needed to understand predictors of being bullied among males in this region.