ORCID Profile
0000-0003-0901-9149
Current Organisations
Waitemata District Health Board
,
The University of Auckland
,
Medical College of Wisconsin
,
Garvan Institute of Medical Research
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Publications
Antiresorptive Medication Use Is not Associated With Acute Cardiovascular Risk: An Observational Study
Publisher: The Endocrine Society
Date: 21-11-2022
Abstract: Bisphosphonates have been reported to be cardioprotective in some, but not all, studies. It is unknown whether denosumab (Dmab) use protects against cardiovascular events (CVEs). To determine whether oral bisphosphonate (oBP) or Dmab use is associated with CVEs in persons with incident fracture. Participants with an incident minimal trauma fracture from the Sax Institute’s 45 and Up Study, a population-based cohort from NSW, Australia, were followed between 2005/2009 and 2017. Questionnaire data were linked to hospital admissions (Admitted Patients Data Collection [APDC]) by the Centre for Health Record Linkage). Medicare Benefit Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) data sets were provided by Services Australia. Data was stored in a secure computing environment (Secure Unified Research Environment). Fractures, CVEs, and comorbidities were identified from the APDC and oBP and Dmab medication from the PBS. oBP and Dmab users were matched to never users (NoRx) by propensity scores. The main outcome measures were association between oBP and Dmab with CVE (acute myocardial infarction, unstable angina, cerebrovascular accident, and transient ischemic attack) and were determined using a stratified Cox's proportional hazards model. There were 880 pairs of oBP and NoRx (616 women) and 770 pairs of Dmab and NoRx (615 women) followed for ∼4.3 years. CVE risk was similar for oBP and NoRx Hazard Ratios (HR) women, 0.88 [95% CI 0.65-1.18] men, 1.07 [95% CI 0.72-1.57]). Similar findings were obtained for Dmab (Hazard Ratios (HR) women, 1.08 [95% CI 0.78-1.50] men, 1.55 [95% CI 0.96-2.48]). oBP and Dmab use was not associated with CVEs.
Heterozygous loss of WBP11 function causes multiple congenital defects in humans and mice
Publisher: Oxford University Press (OUP)
Date: 15-11-2021
DOI: 10.1093/HMG/DDAA258
Abstract: The genetic causes of multiple congenital anomalies are incompletely understood. Here, we report novel heterozygous predicted loss-of-function (LoF) and predicted damaging missense variants in the WW domain binding protein 11 (WBP11) gene in seven unrelated families with a variety of overlapping congenital malformations, including cardiac, vertebral, tracheo-esophageal, renal and limb defects. WBP11 encodes a component of the spliceosome with the ability to activate pre-messenger RNA splicing. We generated a Wbp11 null allele in mouse using CRISPR-Cas9 targeting. Wbp11 homozygous null embryos die prior to E8.5, indicating that Wbp11 is essential for development. Fewer Wbp11 heterozygous null mice are found than expected due to embryonic and postnatal death. Importantly, Wbp11 heterozygous null mice are small and exhibit defects in axial skeleton, kidneys and esophagus, similar to the affected in iduals, supporting the role of WBP11 haploinsufficiency in the development of congenital malformations in humans. LoF WBP11 variants should be considered as a possible cause of VACTERL association as well as isolated Klippel-Feil syndrome, renal agenesis or esophageal atresia.
Muscle Strength and Physical Performance Improve Fracture Risk Prediction Beyond Garvan and FRAX : The Osteoporotic Fractures in Men (MrOS ) Study
Publisher: Wiley
Date: 08-12-2021
DOI: 10.1002/JBMR.4483
Abstract: Muscle strength and physical performance are associated with fracture risk in men. However, it is not known whether these measurements enhance fracture prediction beyond Garvan and FRAX tools. A total of 5665 community‐dwelling men, aged ≥65 years, from the Osteoporotic Fractures in Men (MrOS) Study, who had data on muscle strength (grip strength) and physical performance (gait speed and chair stand tests), were followed from 2000 to 2019 for any fracture, major osteoporotic fracture (MOF), initial hip, and any hip fracture. The contributions to different fracture outcomes were assessed using Cox's proportional hazard models. Tool‐specific analysis approaches and outcome definitions were used. The added predictive values of muscle strength and physical performance beyond Garvan and FRAX were assessed using categorical net reclassification improvement (NRI) and relative importance analyses. During a median follow‐up of 13 (interquartile range 7–17) years, there were 1014 fractures, 536 MOFs, 215 initial hip, and 274 any hip fractures. Grip strength and chair stand improved prediction of any fracture (NRI for grip strength 3.9% and for chair stand 3.2%) and MOF (5.2% and 6.1%). Gait speed improved prediction of initial hip (5.7%) and any hip (7.0%) fracture. Combining grip strength and the relevant performance test further improved the models (5.7%, 8.9%, 9.4%, and 7.0% for any, MOF, initial, and any hip fractures, respectively). The improvements were predominantly driven by reclassification of those with fracture to higher risk categories. Apart from age and femoral neck bone mineral density, muscle strength and performance were ranked equal to or better than the other risk factors included in fracture models, including prior fractures, falls, smoking, alcohol, and glucocorticoid use. Muscle strength and performance measurements improved fracture risk prediction in men beyond Garvan and FRAX. They were as or more important than other established risk factors. These measures should be considered for inclusion in fracture risk assessment tools. © 2021 American Society for Bone and Mineral Research (ASBMR).
Aboriginal and Torres Strait Islander Women’s Access to and Interest in mHealth: National Web-based Cross-sectional Survey
Publisher: JMIR Publications Inc.
Date: 06-03-2023
DOI: 10.2196/42660
Abstract: Health programs delivered through digital devices such as mobile phones (mobile health [mHealth]) have become an increasingly important component of the health care tool kit. Aboriginal and Torres Strait Islander women of reproductive age are likely to be caring for children and family members and needing health care, but little is known about their access to and interest in mHealth. The objectives of this study were to investigate Aboriginal and Torres Strait Islander women’s ownership of digital devices, access to the internet, current mHealth use, and interest and preferences for future mHealth. We examined the factors (age, remoteness, caring for a child younger than 5 years, and level of education) associated with the ownership of digital devices, use of internet, and interest in using a mobile phone to improve health. This study also examines if women are more likely to use mHealth for topics that they are less confident to talk about face-to-face with a health professional. A national web-based cross-sectional survey targeting Aboriginal and Torres Strait Islander women of reproductive age (16-49 years) was performed. Descriptive statistics were reported, and logistic regressions were used to examine the associations. In total, 379 women completed the survey 89.2% (338/379) owned a smartphone, 53.5% (203/379) a laptop or home computer, 35.6% (135/379) a tablet, and 93.1% (353/379) had access to the internet at home. Most women used social media (337/379, 88.9%) or the internet (285/379, 75.2%) everyday. The most common modality used on the mobile phone for health was Google (232/379, 61.2%), followed by social media (195/379, 51.5%). The most preferred modality for future programs was SMS text messaging (211/379, 55.7%) and social media (195/379, 51.4%). The most preferred topics for future mHealth programs were healthy eating (210/379, 55.4%) and cultural engagement (205/379, 54.1%). Women who were younger had greater odds of owning a smartphone, and women with tertiary education were more likely to own a tablet or laptop. Older age was associated with interest to use telehealth, and higher educational attainment was associated with interest for videoconferencing. Most women (269/379, 70.9%) used an Aboriginal medical service and overall reported high rates of confidence to discuss health topics with a health professional. Overall, women showed a similar likelihood of selecting a topic in mHealth whether they were or were not confident to talk to a health professional about that. Our study found that Aboriginal and Torres Strait Islander women were avid users of the internet and had strong interest in mHealth. Future mHealth programs for these women should consider utilizing SMS text messaging and social media modalities and including content on nutrition and culture. A noteworthy limitation of this study was that participant recruitment was web-based (due to COVID-19 restrictions).
Understanding End-User Perspectives of Mobile Pulmonary Rehabilitation (mPR): Cross-Sectional Survey and Interviews (Preprint)
Publisher: JMIR Publications Inc.
Date: 14-07-2019
Abstract: ulmonary rehabilitation (PR) is an effective intervention for the management of people with chronic respiratory diseases, but the uptake of and adherence to PR programs is low. There is potential for mobile health (mHealth) to provide an alternative modality for the delivery of PR, overcoming many of the barriers contributing to poor attendance to current services. he objective of this study was to understand the needs, preferences, and priorities of end users for the development of an adaptive mobile PR (mPR) support program. mixed methods (qualitative and quantitative) approach was used to assess the needs, preferences, and priorities of the end users (ie, patients with chronic respiratory disorders) and key stakeholders (ie, clinicians working with patients with chronic respiratory disorders and running PR). The formative studies included the following: (1) a survey to understand the preferences and priorities of patients for PR and how mobile technology could be used to provide PR support, (2) ethnographic semistructured interviews with patients with chronic respiratory disorders to gain perspectives on their understanding of their health and potential features that could be included in an mPR program, and (3) key informant interviews with health care providers to understand the needs, preferences, and priorities for the development of an mPR support program. cross all formative studies (patient survey, n=30 patient interviews, n=8 and key stakeholder interviews, n=8), the participants were positive about the idea of an mPR program but raised concerns related to digital literacy and confidence in using technology, access to technology, and loss of social support currently gained from traditional programs. Key stakeholders highlighted the need for patient safety to be maintained and ensuring appropriate programs for different groups within the population. Finding a balance between ensuring safety and maximizing access was seen to be essential in the success of an mPR program. hese formative studies found high interest in mHealth-based PR intervention and detailed the potential for an mPR program to overcome current barriers to accessing traditional PR programs. Key considerations and features were identified, including the importance of technology access and digital literacy being considered in utilizing technology with this population.
The association between multimorbidity and osteoporosis investigation and treatment in high-risk fracture patients in Australia: A prospective cohort study
Publisher: Public Library of Science (PLoS)
Date: 17-01-2023
DOI: 10.1371/JOURNAL.PMED.1004142
Abstract: Multimorbidity is common among fracture patients. However, its association with osteoporosis investigation and treatment to prevent future fractures is unclear. This limited knowledge impedes optimal patient care. This study investigated the association between multimorbidity and osteoporosis investigation and treatment in persons at high risk following an osteoporotic fracture. The Sax Institute’s 45 and Up Study is a prospective population-based cohort of 267,153 people in New South Wales, Australia, recruited between 2005 and 2009. This analysis followed up participants until 2017 for a median of 6 years (IQR: 4 to 8). Questionnaire data were linked to hospital admissions (Admitted Patients Data Collection (APDC)), emergency presentations (Emergency Department Data Collection (EDDC)), Pharmaceutical Benefits Scheme (PBS), and Medicare Benefits Schedule (MBS). Data were linked by the Centre for Health Record Linkage and stored in a secured computing environment. Fractures were identified from APDC and EDDC, Charlson Comorbidity Index (CCI) from APDC, Dual-energy X-ray absorptiometry (DXA) investigation from MBS, and osteoporosis treatment from PBS. Out of 25,280 persons with index fracture, 10,540 were classified as high-risk based on 10-year Garvan Fracture Risk (age, sex, weight, prior fracture and falls) threshold ≥20%. The association of CCI with likelihood of investigation and treatment initiation was determined by logistic regression adjusted for education, socioeconomic and lifestyle factors). The high-risk females and males averaged 77 ± 10 and 86 ± 5 years, respectively % had a CCI ≥2. Only 17% of females and 7% of males received a DXA referral, and 22% of females and 14% males received osteoporosis medication following fracture. A higher CCI was associated with a lower probability of being investigated [adjusted OR, females: 0.73 (95% CI, 0.61 to 0.87) and 0.43 (95% CI, 0.30 to 0.62) males: 0.47 (95% CI, 0.33 to 0.68) and 0.52 (0.31 to 0.85) for CCI: 2 to 3, and ≥4 versus 0 to 1, respectively] and of receiving osteoporosis medication [adjusted OR, females: 0.85 (95% CI, 0.74 to 0.98) and 0.78 (95% CI, 0.61 to 0.99) males: 0.75 (95% CI, 0.59 to 0.94) and 0.37 (95% CI, 0.23 to 0.53) for CCI: 2 to 3, and ≥4 versus 0 to 1, respectively]. The cohort is relatively healthy therefore, the impact of multimorbidity on osteoporosis management may have been underestimated. Multimorbidity contributed significantly to osteoporosis treatment gap. This suggests that fracture risk is either underestimated or underprioritized in the context of multimorbidity and highlights the need for extra vigilance and improved fracture care in this setting.
KIAA1217 : A novel candidate gene associated with isolated and syndromic vertebral malformations
Publisher: Wiley
Date: 05-05-2020
DOI: 10.1002/AJMG.A.61607
Progress in the Understanding of the Genetic Etiology of Vertebral Segmentation Disorders in Humans
Publisher: Wiley
Date: 23-12-2008
DOI: 10.1111/J.1749-6632.2008.03452.X
Abstract: Vertebral malformations contribute substantially to the pathophysiology of kyphosis and scoliosis, common health problems associated with back and neck pain, disability, cosmetic disfigurement, and functional distress. This review explores (1) recent advances in the understanding of the molecular embryology underlying vertebral development and relevance to elucidation of etiologies of several known human vertebral malformation syndromes (2) outcomes of molecular studies elucidating genetic contributions to congenital and sporadic vertebral malformation and (3) complex interrelationships between genetic and environmental factors that contribute to the pathogenesis of isolated syndromic and nonsyndromic congenital vertebral malformation. Discussion includes exploration of the importance of establishing improved classification systems for vertebral malformation, future directions in molecular and genetic research approaches to vertebral malformation, and translational value of research efforts to clinical management and genetic counseling of affected in iduals and their families.
Understanding End-User Perspectives of Mobile Pulmonary Rehabilitation (mPR): Cross-Sectional Survey and Interviews
Publisher: JMIR Publications Inc.
Date: 20-12-2019
DOI: 10.2196/15466
Abstract: Pulmonary rehabilitation (PR) is an effective intervention for the management of people with chronic respiratory diseases, but the uptake of and adherence to PR programs is low. There is potential for mobile health (mHealth) to provide an alternative modality for the delivery of PR, overcoming many of the barriers contributing to poor attendance to current services. The objective of this study was to understand the needs, preferences, and priorities of end users for the development of an adaptive mobile PR (mPR) support program. A mixed methods (qualitative and quantitative) approach was used to assess the needs, preferences, and priorities of the end users (ie, patients with chronic respiratory disorders) and key stakeholders (ie, clinicians working with patients with chronic respiratory disorders and running PR). The formative studies included the following: (1) a survey to understand the preferences and priorities of patients for PR and how mobile technology could be used to provide PR support, (2) ethnographic semistructured interviews with patients with chronic respiratory disorders to gain perspectives on their understanding of their health and potential features that could be included in an mPR program, and (3) key informant interviews with health care providers to understand the needs, preferences, and priorities for the development of an mPR support program. Across all formative studies (patient survey, n=30 patient interviews, n=8 and key stakeholder interviews, n=8), the participants were positive about the idea of an mPR program but raised concerns related to digital literacy and confidence in using technology, access to technology, and loss of social support currently gained from traditional programs. Key stakeholders highlighted the need for patient safety to be maintained and ensuring appropriate programs for different groups within the population. Finding a balance between ensuring safety and maximizing access was seen to be essential in the success of an mPR program. These formative studies found high interest in mHealth-based PR intervention and detailed the potential for an mPR program to overcome current barriers to accessing traditional PR programs. Key considerations and features were identified, including the importance of technology access and digital literacy being considered in utilizing technology with this population.
Development of a Culturally Tailored Text Message Maternal Health Program: TextMATCH
Publisher: JMIR Publications Inc.
Date: 20-04-2017
DOI: 10.2196/MHEALTH.7205
Molecular diagnosis of vertebral segmentation disorders in humans
Publisher: Informa UK Limited
Date: 10-2008
DOI: 10.1517/17530059.2.10.1107
Abstract: Vertebral malformations contribute substantially to the pathophysiology of kyphosis and scoliosis, common health problems associated with back and neck pain, disability, cosmetic disfigurement and functional distress. To provide an overview of the current understanding of vertebral malformations, at both the clinical level and the molecular level, and factors that contribute to their occurrence. The literature related to the following was reviewed: recent advances in the understanding of the molecular embryology underlying vertebral development and relevance to elucidation of etiologies of several known human vertebral malformation syndromes outcomes of molecular studies elucidating genetic contributions to congenital and sporadic vertebral malformations and complex interrelationships between genetic and environmental factors that contribute to the pathogenesis of isolated syndromic and non-syndromic congenital vertebral malformations. Expert opinions extend to discussion of the importance of establishing improved classification systems for vertebral malformation, future directions in molecular and genetic research approaches to vertebral malformation and translational value of research efforts to clinical management and genetic counseling of affected in iduals and their families.
Examining Development Processes for Text Messaging Interventions to Prevent Cardiovascular Disease: Systematic Literature Review (Preprint)
Publisher: JMIR Publications Inc.
Date: 13-09-2018
Abstract: nterventions delivered by mobile phones have the potential to prevent cardiovascular disease (CVD) by supporting behavior change toward healthier lifestyles and treatment adherence. To allow replication and adaptation of these interventions across settings, it is important to fully understand how they have been developed. However, the development processes of these interventions have not previously been systematically examined. his study aimed to systematically describe and compare the development process of text messaging interventions identified in the Text2PreventCVD systematic review. e extracted data about the development process of the 9 interventions identified in the Text2PreventCVD systematic review. Data extraction, which was guided by frameworks for the development of complex interventions, considered the following development stages: intervention planning, design, development, and pretesting. Following data extraction, we invited the developers of the interventions to contribute to our study by reviewing the accuracy of the extracted data and providing additional data not reported in the available publications. comprehensive description of the development process was available for 5 interventions. Multiple methodologies were used for the development of each intervention. Intervention planning involved gathering information from stakeholder consultations, literature reviews, examination of relevant theory, and preliminary qualitative research. Intervention design involved the use of behavior change theories and behavior change techniques. Intervention development involved (1) generating message content based on clinical guidelines and expert opinions (2) conducting literature reviews and primary qualitative research to inform decisions about message frequency, timing, and level of tailoring and (3) gathering end-user feedback concerning message readability, intervention acceptability, and perceived utility. Intervention pretesting involved pilot studies with s les of 10 to 30 participants receiving messages for a period ranging from 1 to 4 weeks. he development process of the text messaging interventions examined was complex and comprehensive, involving multiple studies to guide decisions about the scope, content, and structure of the interventions. Additional research is needed to establish whether effective messaging systems can be adapted from work already done or whether this level of development is needed for application in other conditions and settings.
Muscle Strength and Physical Performance Are Associated With Risk of Postfracture Mortality But Not Subsequent Fracture in Men
Publisher: Wiley
Date: 06-07-2022
DOI: 10.1002/JBMR.4619
Abstract: Muscle strength and physical performance are associated with incident fractures and mortality. However, their role in the risk of subsequent fracture and postfracture mortality is not clear. We assessed the association between muscle strength (grip strength) and performance (gait speed and chair stands time) and the risk of subsequent fracture and mortality in 830 men with low‐trauma index fracture, who participated in the Osteoporotic Fractures in Men (MrOS) USA Study and had their index measurements assessed within 5 years prior to the index fracture. The annual decline in muscle strength and performance following index fracture, estimated using linear mixed‐effects regression, was also examined in relation to mortality. The associations were assessed using Cox proportional hazards models adjusted for age, femoral neck bone mineral density (FN BMD), prior fractures, falls, body mass index (BMI), index fracture site, lifestyle factors, and comorbidities. Over a median follow‐up of 3.7 (interquartile range [IQR], 1.3–8.1) years from index fracture to subsequent fracture, 201 (24%) men had a subsequent fracture and over 5.1 (IQR, 1.8–9.6) years to death, and 536 (65%) men died. Index measurements were not associated with subsequent fracture (hazard ratios [HRs] ranging from 0.97 to 1.07). However, they were associated with postfracture mortality. HR (95% confidence interval [CI]) per 1 standard deviation (1‐SD) decrement in grip strength: HR 1.12 (95% CI, 1.01–1.25) and gait speed: HR 1.14 (95% CI, 1.02–1.27), and 1‐SD increment in chair stands time: HR 1.08 (95% CI, 0.97–1.21). Greater annual declines in these measurements were associated with higher mortality risk, independent of the index values and other covariates. HR (95% CI) per 1‐SD annual decrement in change in grip strength: HR 1.15 (95% CI, 1.01–1.33) and in gait speed: HR 1.38 (95% CI, 1.13–1.68), and 1‐SD annual increment in chair stands time: HR 1.28 (95% CI, 1.07–1.54). Men who were unable to complete one or multiple tests had greater risk of postfracture mortality (24%–109%) compared to those performed all tests. It remains to be seen whether improvement in these modifiable factors can reduce postfracture mortality. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
Prevention of Hip Fractures: Trade‐off between Minor Benefits to Individuals and Large Benefits to the Community
Publisher: Wiley
Date: 26-09-2023
DOI: 10.1002/JBMR.4907
Abstract: Goeffrey Rose postulated that a population‐based measure bringing a small benefit to each in idual can yield large benefits to the community. We aimed to test this axiom by quantifying the relationship between change in bone mineral density (BMD) and hip fracture incidence between two prospective cohorts separated by ~10 years. In this prospective population‐based Dubbo Osteoporosis Epidemiology Study (DOES), the participants aged 60+ were recruited in two waves: the initial cohort (1311 women, 842 men) in 1989‐1992, and the second cohort (974 women, 544 men) in 1999‐2001. The incident hip fracture was radiologically ascertained. Femoral neck BMD was measured biannually. Multivariable‐adjusted Cox's proportional hazards models were adjusted for the predefined covariates such as age, BMI, lifestyle factors, falls, and prior fracture. Compared with the initial cohort, the second cohort had a higher femoral neck BMD by ~ 0.04 g/cm 2 in women and 0.03 g/cm 2 in men. However, the prevalence of osteoporosis in the second cohort was halved (prevalence ratio 0.51, 95% CI 0.36‐0.73 in women 0.45, 0.24‐0.84 in men), and its hip fracture incidence was significantly reduced (hazard ratio 0.54, 95% CI, 0.38‐0.78 in women 0.39, 0.19‐0.80 in men). Sensitivity analyses indicated that the “effect” was unlikely due to unmeasured confounders. These findings suggest that a population‐wide strategy aiming at enhancing BMD across the entire population could lead to a substantial decrease in the incidence of hip fractures. This article is protected by copyright. All rights reserved.
Effects and costs of real-time cardiac telerehabilitation: Randomised controlled non-inferiority trial
Publisher: BMJ
Date: 27-08-2019
DOI: 10.1136/HEARTJNL-2018-313189
Abstract: Compare the effects and costs of remotely monitored exercise-based cardiac telerehabilitation (REMOTE-CR) with centre-based programmes (CBexCR) in adults with coronary heart disease (CHD). Participants were randomised to receive 12 weeks of telerehabilitation or centre-based rehabilitation. REMOTE-CR provided in idualised exercise prescription, real-time exercise monitoring/coaching and theory-based behavioural strategies via a bespoke telerehabilitation platform CBexCR provided in idualised exercise prescription and coaching via established rehabilitation clinics. Outcomes assessed at baseline, 12 and/or 24 weeks included maximal oxygen uptake (V̇O 2 max, primary) modifiable cardiovascular risk factors, exercise adherence, motivation, health-related quality of life and programme delivery, hospital service utilisation and medication costs. The primary hypothesis was a non-inferior between-group difference in V̇O 2 max at 12 weeks (inferiority margin=−1.25 mL/kg/min) inferiority margins were not set for secondary outcomes. 162 participants (mean 61±12.7 years, 86% men) were randomised. V̇O 2 max was comparable in both groups at 12 weeks and REMOTE-CR was non-inferior to CBexCR (REMOTE-CR-CBexCR adjusted mean difference (AMD)=0.51 (95% CI −0.97 to 1.98) mL/kg/min, p=0.48). REMOTE-CR participants were less sedentary at 24 weeks (AMD=−61.5 (95% CI −117.8 to −5.3) min/day, p=0.03), while CBexCR participants had smaller waist (AMD=1.71 (95% CI 0.09 to 3.34) cm, p=0.04) and hip circumferences (AMD=1.16 (95% CI 0.06 to 2.27) cm, p=0.04) at 12 weeks. No other between-group differences were detected. Per capita programme delivery (NZD1130/GBP573 vs NZD3466/GBP1758) and medication costs (NZD331/GBP168 vs NZD605/GBP307, p=0.02) were lower for REMOTE-CR. Hospital service utilisation costs were not statistically significantly different (NZD3459/GBP1754 vs NZD5464/GBP2771, p=0.20). REMOTE-CR is an effective, cost-efficient alternative delivery model that could—as a complement to existing services—improve overall utilisation rates by increasing reach and satisfying unique participant preferences.
Examining Development Processes for Text Messaging Interventions to Prevent Cardiovascular Disease: Systematic Literature Review
Publisher: JMIR Publications Inc.
Date: 29-03-2019
DOI: 10.2196/12191
Aboriginal and Torres Strait Islander Women’s Access to and Interest in mHealth: National Web-based Cross-sectional Survey (Preprint)
Publisher: JMIR Publications Inc.
Date: 12-09-2022
Abstract: ealth programs delivered through digital devices such as mobile phones (mobile health [mHealth]) have become an increasingly important component of the health care tool kit. Aboriginal and Torres Strait Islander women of reproductive age are likely to be caring for children and family members and needing health care, but little is known about their access to and interest in mHealth. he objectives of this study were to investigate Aboriginal and Torres Strait Islander women’s ownership of digital devices, access to the internet, current mHealth use, and interest and preferences for future mHealth. We examined the factors (age, remoteness, caring for a child younger than 5 years, and level of education) associated with the ownership of digital devices, use of internet, and interest in using a mobile phone to improve health. This study also examines if women are more likely to use mHealth for topics that they are less confident to talk about face-to-face with a health professional. national web-based cross-sectional survey targeting Aboriginal and Torres Strait Islander women of reproductive age (16-49 years) was performed. Descriptive statistics were reported, and logistic regressions were used to examine the associations. n total, 379 women completed the survey 89.2% (338/379) owned a smartphone, 53.5% (203/379) a laptop or home computer, 35.6% (135/379) a tablet, and 93.1% (353/379) had access to the internet at home. Most women used social media (337/379, 88.9%) or the internet (285/379, 75.2%) everyday. The most common modality used on the mobile phone for health was Google (232/379, 61.2%), followed by social media (195/379, 51.5%). The most preferred modality for future programs was SMS text messaging (211/379, 55.7%) and social media (195/379, 51.4%). The most preferred topics for future mHealth programs were healthy eating (210/379, 55.4%) and cultural engagement (205/379, 54.1%). Women who were younger had greater odds of owning a smartphone, and women with tertiary education were more likely to own a tablet or laptop. Older age was associated with interest to use telehealth, and higher educational attainment was associated with interest for videoconferencing. Most women (269/379, 70.9%) used an Aboriginal medical service and overall reported high rates of confidence to discuss health topics with a health professional. Overall, women showed a similar likelihood of selecting a topic in mHealth whether they were or were not confident to talk to a health professional about that. ur study found that Aboriginal and Torres Strait Islander women were avid users of the internet and had strong interest in mHealth. Future mHealth programs for these women should consider utilizing SMS text messaging and social media modalities and including content on nutrition and culture. A noteworthy limitation of this study was that participant recruitment was web-based (due to COVID-19 restrictions).
Related Organisations
William S Middleton Memorial Veterans Hospital
Location: United States of America
Leibniz-Institut Für Analytische Wissenschaften-ISAS
Location: Germany
University Of Cambridge
Location: United Kingdom of Great Britain and Northern Ireland
NewYork-Presbyterian Hospital/Weill Cornell Medical Center
Location: United States of America
New York University School Of Medicine & Sackler Institute Of Biomedical Sciences
Location: United States of America
Columbia University Columbia College
Location: United States of America
Clement J Zablocki VA Medical Center
Location: United States of America
Related Funding Activities
No related grants have been discovered for Robyn Whittaker.