Development of a dietary application for the management of hemodialysis patients in the United Arab Emirates. Cosette Fakih El Khoury

Transcription

1 Development of a dietary application for the management of hemodialysis patients in the United Arab Emirates Cosette Fakih El Khoury

2 Learning Objectives Become Familiar with the evidence available on effectiveness of Dietary Apps Understand key concepts influencing effectiveness of dietary apps Become familiar with the usercentered approach Describe the steps involved in the development of a dietary app

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6 About 10% of cell phone users in the middle east report using their phone to access health information (Pew Research Center, 2014); Health related applications have gained popularity, as tools to support users in the change of a target behavior (Bhuyan, et al., 2016) Most publications on dietary apps are in the areas of Obesity & Diabetes (Fakih-El Khoury, unpublished) Mhealth apps on the rise

7 Main content of obesity apps, (Nikolaou & Lean, 2017) Only 0.05% of developed apps included identifiable professional input

8 Dietary Mobile apps in CKD Only 5 studies were identified None of the apps were on smartphones, mainly personal digital assistants (PDA) Mainly self-monitoring apps Positive effects on nutritional outcomes

9 Most information comes from studies in Obesity & Diabetes Management Some studies examined commercial apps, others evaluated self-developed apps Short duration (3-6months) Most included a Theory of behavioral change Dietary apps in chronic disease: A Systematic Review (Fakih-El Khoury et al, unpublished)

10 Self-monitoring tools In-app Education Tools for nutrient calculations, Self-monitoring, Food diaries Notifications/SMS Podcasts Recipes videos Dietary Apps

11 Dietary mobile apps publications Mobile apps as sole intervention Comprehensive interventions (multiple arms) Counseling interventions using apps Dietary apps in chronic disease: A Systematic Review, (Fakih-El Khoury et al, unpublished)

12 Main Results Incorporating dietary apps with counseling interventions outperforms using apps alone and counseling alone Provide positive results on nutritional outcomes but not superior to traditional selfmonitoring tools Self-monitoring dietary apps are reliable tools

13 Self monitoring Counselor Feedback Key Components to Effective Apps Social Support Structured Programs Tailored to the End Users

14 Questions to ask Long term efficacy? Content reliability, validity & compliance to guidelines? Educational apps? Promising but data is scarce Commercial apps?

15 App development

16 (Schnall, et al., 2016)

17 Relevance Cycle Understand the end user In depth interviews Identify the needs of the end user Design Cycle Patients involvement in the different design steps Rigor Cycle In depth interview with patients, dietitians and physicians ISR Framework

18 Holden et al 2010 Technology Acceptance Model

19 In-app education Selfmonitoring Podcasts Videos Self-monitoring of dietary intakes Notifications Amended Local Recipes Self-monitoring of laboratory values

20 In-app Education Amendment of Validated educational material in Arabic to : Mobile application Cultural Context Karavetian et al 2015

21 In-app education Constructs of Transtheoretical Model & Reasoned Action Approach

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26 Accuracy of content in line with recent guidelines Language Cultural sensitivity (educational materials, recipes, design ) The case of KELA.UAE a tailor made app

27 Limitations Self-monitoring of diet Lack of Arabic and culturally specific online databases Phase 2: Incorporation of communication with healthcare providers IOS

28 References Holden, R., & Karsh, B.-T. (2010). The Technology Acceptance Model: Its past and its future in health care. Journal of Biomedical Informatics, Schnall, R., Rojas, M., Bakken, S., Brown III, W., Carballo-Dieguez, A., Carry, M.,... Travers, J. (2016). A user-centered model for designing consumer mobile health (mhealth) applications (apps). Journal of Biomedical Informatics, Khaylis, A., Yiaslas, T., Bergstrom, J., & Gore-Felton, C. (2010). A Review of Efficacious Technology-Based Weight-Loss Interventions: Five Key Components. Telemedicine and ehealth, 16(9), Boyce, B. (2014). Nutrition Apps: Opportunities to Guide Patients and Grow your Career. Journal of the Academy of Nutrition and Dietetics, 114, Bhuyan, S., Lu, N., Chandak, A., Kim, H., Wyant, D., Bhatt, J.,... Chang, C. (2016). Use of Mobile Health Applications for Health-Seeking Behavior Among US Adults. J Med Syst, 153. Pew Research Center. (2016). Smartphone Ownership and Internet Usage Continues to Climb in Emerging Economies. Pew Research Center.

29 References Pew Research Center. (2014). Emerging Nations Embrace Internet, Mobile Thechnology. Cell phones nearly Ubiquitous in Many Countries. Pew Research Center. Campbell, J., & Porter, J. (2015). Dietary mobile apps and their effect on nutritional indicators in chronic renal disease: A systematic review. Nephrology, DiFilipo, K., Huang, W.-H., Andrade, J., & Chapman-Novakofski, K. (2015). The use of mobile apps to improve nutrition outcomes: A systematic literature review. Journal of Telemedine and Telecare Park, L., Beatty, A., Stafford, Z., & Whooley, M. (2016). Mobile Phone Interventions for the Secondary Prevention of Cardiovascular Disease. Progress in Cardiovascular Diseases. Porter, J., Huggins, C., Truby, H., & Collins, J. (2016). The Effect of Using Mobile Technology-Based Methods That Record Food or Nutrient Intake on Diabetes Outcome: A systematic Review. Nutrients, 815.