Background: In sub-Saharan Africa, the disease burden from skin diseases, including skin-related neglected tropical diseases (skin NTDs), is extremely high. These diseases often are overlooked due to limited access to health care stemming from, for example, remote geographical locations and a lack of experts. To address these gaps, we developed a mobile health app, eSkinHealth, which is a field-adapted platform to serve as a portable electronic patient chart and for teledermatology. Objective: The purpose of the study is to evaluate the usability and effectiveness of the app in rural Côte d’Ivoire for diagnosing and managing skin NTDs and other skin diseases. Methods: A 2-arm trial with local health care providers and patients with skin diseases was implemented over a 3-month period. The providers were assigned to an intervention receiving the eSkinHealth app or control with usual care. Four nurses and 8 community health care workers participated in each arm. The training was provided on the use of the app to the intervention arm only, while both arms were trained on skin diseases. For the usability study, we evaluated our approach with the System Usability Scale (SUS) and in-depth interviews. For the effectiveness study, our primary outcome was to evaluate the detection and management of 5 skin NTDs as our targeted diseases, namely, Buruli ulcer, leprosy, lymphatic filariasis, scabies, and yaws, using the eSkinHealth app. Procedures of our methods were reviewed and approved by the institutional review board of the Ministry of Health and by Tulane University. Results: The mean age of our participants (providers) was 40.5 and 42.5 years for the intervention and control arms, respectively, and all were male (n=24). The average SUS scores taken from the intervention arm at baseline, the midpoint (6 weeks), and the end of study (12 weeks) were 72.3 (SD 11.5), 72.3 (SD 12.4), and 86.3 (SD 10.8), respectively. All participants interviewed, including 4 dermatologists and program managers, were satisfied with the app. Especially community health care workers felt empowered by being equipped with the tool. A total of 79 cases of skin NTDs were reported in the intervention arm as compared to 17 cases in the control arm (P=.002). Besides the skin NTDs, more skin diseases and conditions were reported from the control than from the intervention arm (P<.001). However, 100 cases (66%) were not given any particular diagnosis in the control arm and were documented only as a “dermatosis.” In the intervention arm, 151 cases (72.9%) were diagnosed within the eSkinHealth platform, and the remaining were diagnosed on-site by dermatologists. Conclusions: The study provided evidence for the usability and effectiveness of the eSkinHealth app embedded into our surveillance approach to improve the detection and management of skin NTDs and other skin diseases in Côte d’Ivoire and, furthermore, is expected to contribute to knowledge on mobile health approaches in the control of skin diseases in resource-limited settings. Trial Registration: ClinicalTrials.gov NCT05300399; https://clinicaltrials.gov/ct2/show/NCT05300399

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: The prevalence of skin diseases is extremely high in sub-Saharan Africa, among which are skin neglected tropical diseases (skin NTDs) that could lead to life-long disabilities and deformities if not diagnosed and treated early. To achieve early detection and early treatment of these skin diseases, we developed a mobile health application (mHealth app): ‘eSkinHealth.’ Objective: This paper outlines a protocol for evaluating the effect of our eSkinHealth app in the early detection and effective management of skin diseases in Côte d’Ivoire. Methods: A mixed-methods pilot trial will be conducted in Côte d’Ivoire and will consist of 3 phases: phase 1, the development and improvement of the eSkinHealth app; phase 2, a pilot trial to evaluate the usability of the eSkinHealth app for local medical staff in Côte d’Ivoire; and phase 3, a pilot trial to evaluate the effectiveness of early detection and case management of targeted skin NTDs (Buruli ulcer, leprosy, yaws, and lymphatic filariasis) with the eSkinHealth app in Côte d’Ivoire. The pilot study will be implemented as a 2-arm trial with local healthcare providers and patients with skin NTDs over a 3-month follow-up period. The local healthcare providers will be assigned to an intervention group receiving the eSkinHealth app to be used in their daily practices or a control group. Training will be provided on the usage and implementation of the app and diagnostic pipeline to the intervention group only, while both groups will receive training on skin diseases. Our primary outcome is to evaluate the early detection and effective management of skin diseases using the eSkinHealth app in Côte d’Ivoire by number of cases diagnosed and managed. Additionally, we will evaluate the eSkinHealth app with validated questionnaires and in-depth interviews. Procedures of our methods have been reviewed and approved by the IRB of the Ministry of Health, Côte d’Ivoire and by Tulane University in 2021. Results: This study was funded in 2021. We started enrolment of patients in February 2022, and data collection is currently underway. We expect the first results to be submitted for publication in 2023. Conclusions: Our ‘eSkinHealth’ is a field-adapted platform that could both provide direct diagnostic and management assistance to health workers in remote settings. The study will provide evidence for the usability and the effectiveness of the eSkinHealth app to improve the early detection and case management of skin NTDs in Côte d’Ivoire; and further, are expected to contribute to knowledge on mobile health approaches in the control of skin NTDs. Clinical Trial: 2020-2054 (Clinicaltrials.gov)

Subjective age (i.e., how old one feels) has been found to be a biopsychosocial marker of aging. This study examined the associations between subjective age and the frequency of information and communication technology (ICT) usage by older adults. Data were collected via an online survey conducted in 2020 during the COVID-19 pandemic. The study analyzed responses from participants aged 65 to 89 (M = 71.9, SD = 3.9) who resided in Japan (N = 1631, 52.8% female). Subjective age was indexed by asking participants to specify in years how old they felt. Proportional discrepancy scores (PDS) were calculated to indicate younger or older subjective age and were used as an independent variable. Participants were asked about the frequency of computer, smartphone, flip phone, tablet, and social networking service (SNS) use. Two-thirds of the participants (63.6%) reported feeling younger than their actual age. Nearly 90% reported using computers for more than 2–3 days a week, while 64.3% reported smartphone use, 22.9% reported flip phone use, and 36.6% reported SNS use. Logistic regression analyses revealed that a lower PDS (i.e., feeling younger) was associated with a significantly higher frequency of smartphone use (OR: 0.77; 95% CI: 0.60, 0.98) after adjusting for potential confounders. No such association was found for computer, flip phone, tablet, or SNS use. Our study found that feeling younger was associated with a higher frequency of smartphone use. The daily use of smartphones may have helped older adults stay in touch with family and friends and obtain the information that they needed, which may have contributed to better psychological well-being outcomes, especially during the COVID-19 pandemic.

Various technologies to provide long-term care have been developed in the last decade due to the shortage of caregivers in Japan. However, care technologies are not widely used in long-term care, and the reasons for the lack of acceptance of care technologies are poorly understood. To identify the factors associated with the acceptance of care technologies designed to assist with activities of daily living (i.e., bathing, dressing, toileting, transferring, and eating) among middle-aged and older adults in Japan. A cross-sectional survey was conducted in August 2020. The target population was middle-aged and older adults (i.e., 40–79 years) in Japan. We used an online questionnaire platform of a research company to target people throughout Japan, and measured the acceptance of care technologies to support the performance of each of five activities of daily living. Multivariable logistic regression models were fitted to identify the associated factors using the bivariate variable “willingness to use care technologies for activities of daily living” as the dependent variable. A total of 3261 eligible respondents were included in the analysis. The factors positively associated with the acceptance of care technologies for transferring, which had the highest level of acceptance, were female sex (adjusted odds ratio=1.25, 95% CI: 1.04–1.52), university or higher education level (1.73, 1.41–2.12), an annual income of 39000 to 58999 USD (1.47, 1.08–2.01) or greater than 99,000 USD (1.88, 1.21–2.94), experience as an informal caregiver (1.25, 1.02–1.54), the use of social networking services a few times per year (1.40, 1.11–1.78) or nearly every day (1.47, 1.19–1.82), and willingness to live in a nursing home when care is needed (1.29, 1.05–1.60). In contrast, aged 70–79 years was negatively associated with the acceptance of care technologies for transferring (0.70, 0.52–0.93). Female sex, university or higher education level, an annual income greater than 99,000 USD, the use of social networking services a few times per year or more often, and willingness to live in a nursing home when care is needed were positively associated with the acceptance of care technologies for multiple activities of daily living. Given that many of the respondents will need care in 5–10 years, the acceptance of care technologies among those who need care will increase. Therefore, governments and developers of care technologies could consider the potential needs of this population group.

Background: Documentation tasks comprise a large percentage of nurses’ workloads. Nursing records were partially based on a report from the patient. However, it is not a verbatim transcription of the patient's complaints but a type of medical record. Therefore, to reduce the time spent on nursing documentation, it is necessary to assist in the appropriate conversion or citation of patient reports to professional records. However, few studies have been conducted on systems for capturing patient reports in electronic medical records. In addition, there have been no reports on whether such a system reduces the time spent on nursing documentation. Objective: This study aims to develop a patient self-reporting system that appropriately converts data to nursing records and evaluate its effect on reducing the documenting burden for nurses. Methods: An electronic medical record–connected questionnaire and a preadmission nursing questionnaire were administered. The questionnaire responses entered by the patients were quoted in the patient profile for inpatient assessment in the nursing system. To clarify its efficacy, this study examined whether the use of the electronic questionnaire system saved the nurses’ time entering the patient profile admitted between August and December 2022. It also surveyed the usability of the electronic questionnaire between April and December 2022. Results: A total of 3111 (78%) patients reported that they answered the electronic medical questionnaire by themselves. Of them, 2715 (88%) felt it was easy to use and 2604 (85%) were willing to use it again. The electronic questionnaire was used in 1326 of 2425 admission cases (use group). The input time for the patient profile was significantly shorter in the use group than in the no-use group (P<.001). Stratified analyses showed that in the internal medicine wards and in patients with dependent activities of daily living, nurses took 13%-18% (1.3 to 2 minutes) less time to enter patient profiles within the use group (both P<.001), even though there was no difference in the amount of information. By contrast, in the surgical wards and in the patients with independent activities of daily living, there was no difference in the time to entry (P=.50 and P=.20, respectively), but there was a greater amount of information in the use group. Conclusions: The study developed and implemented a system in which self-reported patient data were captured in the hospital information network and quoted in the nursing system. This system contributes to improving the efficiency of nurses’ task recordings.