Despite their popularity and potential to promote health in large populations, the effectiveness of online social networks (e.g., Facebook) to improve health behaviors has been somewhat disappointing. Most of the research examining the effectiveness of such interventions has used randomized controlled trials (RCTs). It is asserted that the modest outcomes may be due to characteristics specific to both online social networks and RCTs. The highly controlled nature of RCTs stifles the dynamic nature of online social networks. Alternative and ecologically valid research designs that evaluate online social networks in real-life conditions are needed to advance the science in this area.
Vandelanotte, CL orcid:0000-0002-4445-8094 ; Background: More than a million health and well-being apps are available from the Apple and Google app stores. Some apps use built-in mobile phone sensors to generate health data. Clinicians and patients can find information regarding safe and effective mobile health (mHealth) apps in third party-curated mHealth app libraries. Objective: These independent Web-based repositories guide app selection from trusted lists, but do they offer apps using ubiquitous, low-cost smartphone sensors to improve health? This study aimed to identify the types of built-in mobile phone sensors used in apps listed on curated health app libraries, the range of health conditions these apps address, and the cross-platform availability of the apps. Methods: This systematic survey reviewed three such repositories (National Health Service Apps Library, AppScript, and MyHealthApps), assessing the availability of apps using built-in mobile phone sensors for the diagnosis or treatment of health conditions. Results: A total of 18 such apps were identified and included in this survey, representing 1.1% (8/699) to 3% (2/76) of all apps offered by the respective libraries examined. About one-third (7/18, 39%) of the identified apps offered cross-platform Apple and Android versions, with a further 50% (9/18) only dedicated to Apple and 11% (2/18) to Android. About one-fourth (4/18, 22%) of the identified apps offered dedicated diagnostic functions, with a majority featuring therapeutic (9/18, 50%) or combined functionality (5/18, 28%). Cameras, touch screens, and microphones were the most frequently used built-in sensors. Health concerns addressed by these apps included respiratory, dermatological, neurological, and anxiety conditions. Conclusions: Diligent mHealth app library curation, medical device regulation constraints, and cross-platform differences in mobile phone sensor architectures may all contribute to the observed limited availability of mHealth apps using built-in phone sensors in curated mHealth app libraries. However, more efforts are needed to increase the number of such apps on curated lists, as they offer easily accessible low-cost options to assist people in managing clinical conditions.
Purpose: To investigate the direct and indirect effects of sociodemographic/health factors on diet quality through practical nutrition knowledge (PNK) about how to compose a balanced meal. Design: A cross-sectional study using data from an online survey of the 10 000 Steps cohort (data collected November-December 2016). Setting: Australia. Participants: Adults (n = 8161). Response rate was 16.7%. Measures: Self-reported lifestyle, health, and sociodemographic characteristics, including diet quality and PNK. Analysis: The PROCESS macro for SPSS was used to conduct the mediation analyses. Results: Better diet quality was associated with being female, older, more highly educated, and having a lower body mass index. Mediation analysis showed that PNK significantly mediated the associations between sex (a*b = 0.54, 95% confidence interval [CI] = 0.39-0.70) and education (vocational education: a*b = 0.22, 95% CI = 0.12-0.35, university: a*b = 0.48, 95% CI = 0.35-0.64), and diet quality. Practical nutrition knowledge suppressed the association between age and diet quality (a*b = −0.03, 95% CI = −0.04 to −0.03). Conclusion: Variations in diet quality between sociodemographic groups were partially explained by differences in PNK, suggesting that focusing public health efforts on increasing this specific knowledge type might be promising.
Purpose: To evaluate the performance of Facebook advertisements for a physical activity smartphone app at different times of the year. Design: A repeated cross-sectional study examined the cost and engagement levels of advertisements during 3 time points: Post-Easter April-May 2019, Pre-Summer October 2019, and New Year January 2020 . Setting: Advertisements were delivered on Facebook. Subjects: The target population was Australian females aged 25-60 years. Measures: Cost was evaluated in terms of reach per dollar. Engagement was evaluated in terms of click-through and app downloads per reach. Analysis: ANOVA and Chi-square were used to assess differences in reach per dollar, click-through, and app downloads per reach between time points. Results: Reach per dollar was highest in Post-Easter, but declined in Pre-Summer and New Year (reach/$ 34.8 vs 31.5 vs 27.5; p = .004). Click-through was highest in New Year followed by Post-Easter, then Pre-Summer (click-through 3.2% vs 1.9% vs 1.2%; p < .001). New Year and Post-Easter advertisements achieved higher app downloads per reach than Pre-Summer (downloads 0.9% vs 0.7% vs 0.3%; p < .001). Conclusion: Facebook advertisements were cheaper in the first time-point, and appear to be getting more expensive (i.e. declining reach/$). Advertisements in the New Year achieved the highest click-through and app downloads per reach, suggesting a useful time of year to promote physical activity products.
BACKGROUND/OBJECTIVE: The increasing burden of non-communicable diseases (NCDs) in Nepal underscores the importance of strengthening primary healthcare systems to deliver efficient care. In this study, we examined the barriers and facilitators to engaging community health workers (CHWs) for NCDs prevention and control in Nepal. DESIGN: We used multiple approaches including (a) review of relevant literature, (b) key personnel and stakeholders' consultation meetings and (c) qualitative data collection using semistructured interviews. A grounded theory approach was used for qualitative data collection and the data were analysed thematically. SETTING: Data were collected from health facilities across four districts in Nepal and two stakeholder consultative meetings were conducted at central level. PARTICIPANTS: We conducted in-depth interviews with CHWs (Health Assistants, Auxiliary Health Workers, Auxiliary Nurse Midwife) (n=5); key informant interviews with health policymakers/managers (n=3) and focus group discussions (FGDs) with CHWs (four FGDs; total n=27). Participants in two stakeholder consultative meetings included members from the government (n=8), non-government organisations (n=7), private sector (n=3) and universities (n=6). RESULTS: The CHWs were engaged in a wide range of public health programmes and they also deliver NCDs specific programmes such as common NCDs screening, provisional diagnosis, primary care, health education and counselling, basic medication and referral and so on. These NCD prevention and control services are concentrated in those districts, where the WHO, Package for prevention and control of NCDs) program is being implemented. Some challenges and barriers were identified, including inadequate NCD training, high workload, poor system-level support, inadequate remuneration, inadequate supply of logistics and drugs. The facilitating factors included government priority, formation of NCD-related policies, community support systems, social prestige and staff motivation. CONCLUSION: ...
Objective: This study investigated the association between COVID‐19 prevention knowledge and concern and practising preventive behaviour in Australian adults. Methods: Using an online survey, knowledge of Australian COVID‐19 guidelines, concerns about pandemic impact, the practice of preventive behaviours, and sociodemographic variables (i.e. age, gender, information source) were measured. Bivariate analysis and linear regression models were used. Results: A total of 1,491 participants (age 50.5 ±14.9 years, 32.3% males) completed the survey. Higher knowledge and concern scores were associated with a higher practice of preventive behaviour scores (βs:0.47 & 0.08 respectively, p65 years) and women had higher knowledge and practice scores compared to their counterparts. Being younger (<45 years) and male were associated with a lower practice score (βs:‐0.88 & −2.52, respectively, p<0.001). Referring to public and government sources as primary sources of information was associated with a higher practice score (β:1.21, p<0.001). Conclusions: Government‐run campaigns appear to be effective in promoting preventive practices and achieving a high knowledge of COVID‐19 guidelines in Australian adults. Implications for public health: Public health strategies are required to promote the practice of preventive behaviour for COVID‐19 (or future pandemics), especially among men and younger adults using social media, given their wide use of these sources.
Background/objective The increasing burden of non-communicable diseases (NCDs) in Nepal underscores the importance of strengthening primary healthcare systems to deliver efficient care. In this study, we examined the barriers and facilitators to engaging community health workers (CHWs) for NCDs prevention and control in Nepal. Design We used multiple approaches including (a) review of relevant literature, (b) key personnel and stakeholders' consultation meetings and (c) qualitative data collection using semistructured interviews. A grounded theory approach was used for qualitative data collection and the data were analysed thematically. Setting Data were collected from health facilities across four districts in Nepal and two stakeholder consultative meetings were conducted at central level. Participants We conducted in-depth interviews with CHWs (Health Assistants, Auxiliary Health Workers, Auxiliary Nurse Midwife) (n=5); key informant interviews with health policymakers/managers (n=3) and focus group discussions (FGDs) with CHWs (four FGDs; total n=27). Participants in two stakeholder consultative meetings included members from the government (n=8), non-government organisations (n=7), private sector (n=3) and universities (n=6). Results The CHWs were engaged in a wide range of public health programmes and they also deliver NCDs specific programmes such as common NCDs screening, provisional diagnosis, primary care, health education and counselling, basic medication and referral and so on. These NCD prevention and control services are concentrated in those districts, where the WHO, Package for prevention and control of NCDs) program is being implemented. Some challenges and barriers were identified, including inadequate NCD training, high workload, poor system-level support, inadequate remuneration, inadequate supply of logistics and drugs. The facilitating factors included government priority, formation of NCD-related policies, community support systems, social prestige and staff motivation. Conclusion Engaging CHWs has been considered as key driver to delivering NCDs related services in Nepal. Effective integration of CHWs within the primary care system is essential for CHW's capacity buildings, necessary supervisory arrangements, supply of logistics and medications and setting up effective recording and reporting systems for prevention and control of NCDs in Nepal.
