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Usability and Feasibility of a Smartphone App to Assess Human Behavioral Factors Associated with Tick Exposure (The Tick App): Quantitative and Qualitative Study

BACKGROUND: Mobile health (mHealth) technology takes advantage of smartphone features to turn them into research tools, with the potential to reach a larger section of the population in a cost-effective manner, compared with traditional epidemiological methods. Although mHealth apps have been widely...

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Autores principales: Fernandez, Maria P, Bron, Gebbiena M., Kache, Pallavi A, Larson, Scott R, Maus, Adam, Gustafson Jr, David, Tsao, Jean I, Bartholomay, Lyric C, Paskewitz, Susan M, Diuk-Wasser, Maria A
Formato: Online Artículo Texto
Lenguaje:English
Publicado: JMIR Publications 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6913724/
https://www.ncbi.nlm.nih.gov/pubmed/31651409
http://dx.doi.org/10.2196/14769
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author Fernandez, Maria P
Bron, Gebbiena M.
Kache, Pallavi A
Larson, Scott R
Maus, Adam
Gustafson Jr, David
Tsao, Jean I
Bartholomay, Lyric C
Paskewitz, Susan M
Diuk-Wasser, Maria A
author_facet Fernandez, Maria P
Bron, Gebbiena M.
Kache, Pallavi A
Larson, Scott R
Maus, Adam
Gustafson Jr, David
Tsao, Jean I
Bartholomay, Lyric C
Paskewitz, Susan M
Diuk-Wasser, Maria A
author_sort Fernandez, Maria P
collection PubMed
description BACKGROUND: Mobile health (mHealth) technology takes advantage of smartphone features to turn them into research tools, with the potential to reach a larger section of the population in a cost-effective manner, compared with traditional epidemiological methods. Although mHealth apps have been widely implemented in chronic diseases and psychology, their potential use in the research of vector-borne diseases has not yet been fully exploited. OBJECTIVE: This study aimed to assess the usability and feasibility of The Tick App, the first tick research–focused app in the United States. METHODS: The Tick App was designed as a survey tool to collect data on human behaviors and movements associated with tick exposure while engaging users in tick identification and reporting. It consists of an enrollment survey to identify general risk factors, daily surveys to collect data on human activities and tick encounters (Tick Diaries), a survey to enter the details of tick encounters coupled with tick identification services provided by the research team (Report a Tick), and educational material. Using quantitative and qualitative methods, we evaluated the enrollment strategy (passive vs active), the user profile, location, longitudinal use of its features, and users’ feedback. RESULTS: Between May and September 2018, 1468 adult users enrolled in the app. The Tick App users were equally represented across genders and evenly distributed across age groups. Most users owned a pet (65.94%, 962/1459; P<.001), did frequent outdoor activities (recreational or peridomestic; 75.24%, 1094/1454; P<.001 and 64.58%, 941/1457; P<.001, respectively), and lived in the Midwest (56.55%, 824/1457) and Northeast (33.0%, 481/1457) regions in the United States, more specifically in Wisconsin, southern New York, and New Jersey. Users lived more frequently in high-incidence counties for Lyme disease (incidence rate ratio [IRR] 3.5, 95% CI 1.8-7.2; P<.001) and in counties with cases recently increasing (IRR 1.8, 95% CI 1.1-3.2; P=.03). Recurring users (49.25%, 723/1468) had a similar demographic profile to all users but participated in outdoor activities more frequently (80.5%, 575/714; P<.01). The number of Tick Diaries submitted per user (median 2, interquartile range [IQR] 1-11) was higher for older age groups (aged >55 years; IRR 3.4, 95% CI 1.5-7.6; P<.001) and lower in the Northeast (IRR[NE] 0.4, 95% CI 0.3-0.7; P<.001), whereas the number of tick reports (median 1, IQR 1-2) increased with the frequency of outdoor activities (IRR 1.5, 95% CI 1.3-1.8; P<.001). CONCLUSIONS: This assessment allowed us to identify what fraction of the population used The Tick App and how it was used during a pilot phase. This information will be used to improve future iterations of The Tick App and tailor potential tick prevention interventions to the users’ characteristics.
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spelling pubmed-69137242020-03-04 Usability and Feasibility of a Smartphone App to Assess Human Behavioral Factors Associated with Tick Exposure (The Tick App): Quantitative and Qualitative Study Fernandez, Maria P Bron, Gebbiena M. Kache, Pallavi A Larson, Scott R Maus, Adam Gustafson Jr, David Tsao, Jean I Bartholomay, Lyric C Paskewitz, Susan M Diuk-Wasser, Maria A JMIR Mhealth Uhealth Original Paper BACKGROUND: Mobile health (mHealth) technology takes advantage of smartphone features to turn them into research tools, with the potential to reach a larger section of the population in a cost-effective manner, compared with traditional epidemiological methods. Although mHealth apps have been widely implemented in chronic diseases and psychology, their potential use in the research of vector-borne diseases has not yet been fully exploited. OBJECTIVE: This study aimed to assess the usability and feasibility of The Tick App, the first tick research–focused app in the United States. METHODS: The Tick App was designed as a survey tool to collect data on human behaviors and movements associated with tick exposure while engaging users in tick identification and reporting. It consists of an enrollment survey to identify general risk factors, daily surveys to collect data on human activities and tick encounters (Tick Diaries), a survey to enter the details of tick encounters coupled with tick identification services provided by the research team (Report a Tick), and educational material. Using quantitative and qualitative methods, we evaluated the enrollment strategy (passive vs active), the user profile, location, longitudinal use of its features, and users’ feedback. RESULTS: Between May and September 2018, 1468 adult users enrolled in the app. The Tick App users were equally represented across genders and evenly distributed across age groups. Most users owned a pet (65.94%, 962/1459; P<.001), did frequent outdoor activities (recreational or peridomestic; 75.24%, 1094/1454; P<.001 and 64.58%, 941/1457; P<.001, respectively), and lived in the Midwest (56.55%, 824/1457) and Northeast (33.0%, 481/1457) regions in the United States, more specifically in Wisconsin, southern New York, and New Jersey. Users lived more frequently in high-incidence counties for Lyme disease (incidence rate ratio [IRR] 3.5, 95% CI 1.8-7.2; P<.001) and in counties with cases recently increasing (IRR 1.8, 95% CI 1.1-3.2; P=.03). Recurring users (49.25%, 723/1468) had a similar demographic profile to all users but participated in outdoor activities more frequently (80.5%, 575/714; P<.01). The number of Tick Diaries submitted per user (median 2, interquartile range [IQR] 1-11) was higher for older age groups (aged >55 years; IRR 3.4, 95% CI 1.5-7.6; P<.001) and lower in the Northeast (IRR[NE] 0.4, 95% CI 0.3-0.7; P<.001), whereas the number of tick reports (median 1, IQR 1-2) increased with the frequency of outdoor activities (IRR 1.5, 95% CI 1.3-1.8; P<.001). CONCLUSIONS: This assessment allowed us to identify what fraction of the population used The Tick App and how it was used during a pilot phase. This information will be used to improve future iterations of The Tick App and tailor potential tick prevention interventions to the users’ characteristics. JMIR Publications 2019-10-24 /pmc/articles/PMC6913724/ /pubmed/31651409 http://dx.doi.org/10.2196/14769 Text en ©Maria P Fernandez, Gebbiena M. Bron, Pallavi A Kache, Scott R Larson, Adam Maus, David Gustafson Jr, Jean I Tsao, Lyric C Bartholomay, Susan M Paskewitz, Maria A Diuk-Wasser. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 24.10.2019. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR mhealth and uhealth, is properly cited. The complete bibliographic information, a link to the original publication on http://mhealth.jmir.org/, as well as this copyright and license information must be included.
spellingShingle Original Paper
Fernandez, Maria P
Bron, Gebbiena M.
Kache, Pallavi A
Larson, Scott R
Maus, Adam
Gustafson Jr, David
Tsao, Jean I
Bartholomay, Lyric C
Paskewitz, Susan M
Diuk-Wasser, Maria A
Usability and Feasibility of a Smartphone App to Assess Human Behavioral Factors Associated with Tick Exposure (The Tick App): Quantitative and Qualitative Study
title Usability and Feasibility of a Smartphone App to Assess Human Behavioral Factors Associated with Tick Exposure (The Tick App): Quantitative and Qualitative Study
title_full Usability and Feasibility of a Smartphone App to Assess Human Behavioral Factors Associated with Tick Exposure (The Tick App): Quantitative and Qualitative Study
title_fullStr Usability and Feasibility of a Smartphone App to Assess Human Behavioral Factors Associated with Tick Exposure (The Tick App): Quantitative and Qualitative Study
title_full_unstemmed Usability and Feasibility of a Smartphone App to Assess Human Behavioral Factors Associated with Tick Exposure (The Tick App): Quantitative and Qualitative Study
title_short Usability and Feasibility of a Smartphone App to Assess Human Behavioral Factors Associated with Tick Exposure (The Tick App): Quantitative and Qualitative Study
title_sort usability and feasibility of a smartphone app to assess human behavioral factors associated with tick exposure (the tick app): quantitative and qualitative study
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6913724/
https://www.ncbi.nlm.nih.gov/pubmed/31651409
http://dx.doi.org/10.2196/14769
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