The development of specific software programs for the purpose of managing various health conditions is on the rise. The advancements in the mobile phone technology have provided the healthcare system and the public with a chance to download phone applications and use them in the management of diseases. Majeed-Aris et al. (2015) did a systematic review to examine the effectiveness of these mobile apps in the management of chronic physical conditions in the adolescents. This paper will discuss the research article by Majeed-Aris et al. (2015) and analyze its appropriateness for application in the nursing practice. The purpose of the study, the interventions that were done, and methods used to review various articles will be discussed. This paper will also present the main findings. Finally, the paper will analyze if the research is credible. The credibility section will focus on the journal where the research was published; the study design and data collection; measuring instruments and extraneous variables and, finally, it will conclude by explaining whether the findings would be the same if the research would have been done in the USA.
Use of Apps by Adolescents to Support Personal Management of Chronic Conditions
Technological advances have brought notable improvements to the healthcare system. Various innovations have made diagnostic tests convenient and accessible at a low cost. The invention of mobile applications has equally made significant changes in the way healthcare providers and patients managed different health conditions. These applications have improved the accessibility of information, making it easy for people to get informed about health issues without necessarily visiting health care providers for advice. In adolescents, the use of mobile phone technology, particularly apps is rising. Significantly, applications have made it possible for young people to manage their chronic conditions, thus improving their health outcomes. Majeed-Aris et al. (2015) conducted a systematic review to examine the effectiveness of these mobile apps in helping adolescents manage their chronic physical conditions. This paper analyzes the study carried out by Majeed-Aris et al. and examines if it is credible and applicable to recommend the use of mobile apps in the management of diseases in adolescents.
Purpose of the Study
The aim of the study can be understood by reading the abstract. The authors state that the objective of the research is to do a systematic review of various research findings on the effectiveness of mobile apps, which are designed to support adolescents in managing their chronic physical conditions. The topic of the article is in agreement with the study purpose presented in the abstract. Therefore, the readers of this article can know immediately that the study is about reviewing the literature to conclude the effectiveness of mobile or tablet apps in managing long-term chronic physical conditions in adolescents. However, the researchers do not provide the research questions that the study should answer. Similarly, the problem statement is not provided. Despite that, the reader of the article is aware of the purpose of the study.
Data Contribution
The authors state that the study was a systematic review. They assert in the abstract that they reviewed English-language literature that was published since 2003. In the method section, the literature was accessed from five relevant bibliographical databases, which included MEDLINE, Embase, (CINAHL), PsychINFO, and the Web of Science. The articles were searched using three key terms. Since the investigators did not have expertise in searching for the terms, they consulted an information scientist who helped them to come up with a search strategy that used standardized index search terms that relate to the three concepts, (1) Chronic physical conditions, (2) adolescents, and (3) mobile technology. North American and British spellings and terms were used during the search. The authors state that they used free-text terms consistently throughout.
The researchers contend that search sensitivity was necessary to decrease the likelihood of missing out on relevant studies. Therefore, journals that were associated with the most recent retrieved citations were hand searched from 2009 to 2014. Two independent reviewers used quality assessment and data extraction tools to screen titles and abstracts. Since the mobile technology is dynamic, the investigators looked for conference abstracts published in peer-reviewed journals. Additionally, the authors of the articles to be reviewed were contacted with the aim of getting related published and unpublished work regarding mobile technology.
Then, two reviewers used a screening tool that allowed them to outline the inclusion criteria. 782 articles met the criteria and were divided between two teams of two reviewers. The teams, AH, DF and VS, MR, scrutinized the abstracts further using the same screening tool. The teams consulted relevant materials to reach a consensus whenever a disagreement arose in either team. This collaboration and consultation were important because they helped to minimize the bias in interpreting findings.
The inclusion criteria involved articles that addressed adolescents aged from 10 to 24. The articles also needed to include information on apps that focused on management of chronic illnesses. Additionally, the articles were to compare the interventions described in them versus the usual care given to patients. Then, the articles were to examine the outcome of patients regarding attitudinal, physiological, behavioral, or knowledge issues. Finally, the studies to be reviewed should have used controlled clinical trial, randomized controlled trial, case-control study, cohort analytic study, or interrupted time series.
The exclusion criteria included non-English-language publications due to resource limitations. Additionally, studies that focused on the use of mobile technology to only deliver text messages or phone calls were excluded from the review. The whole method of data collection is comprehensive and logical in order to enable the researchers to meet the aim of the study.
Data Collection
A tool that was based on data extraction template for Cochrane reviews was developed to allow continuous extraction of data and to prevent the investigators from overlooking relevant information. Two investigators did the extraction of data independently, and any discrepancies were resolved by discussion with the wider research team. Effective Public Health Practice Project assessment tool was employed to assess the evidence and quality of papers. Data was analyzed using the SPSS Statistics version 22.0 (IBM Corp.). Until the authors begin discussing the results, they do not specify the kind of data that is being collected and thus, the reader of the article can get confused concerning the needed data.
Intervention Testing
The researchers do not indicate anywhere where the intervention was tested.
Main Findings
In the results section, the reader can identify that only 19 full-text papers were eligible for inclusion in the study, and only four met the inclusion criteria. Four apps were found which helped adolescents manage their chronic physical conditions (diabetes, asthma, and cancer). The authors do not state the names of the apps but associate the apps with the investigators who conducted the studies under the review. Another finding is that some adolescents were involved in designing the apps. Additionally, some clinicians participated in coming up with the apps. The results section adequately addresses the effectiveness of these apps as stated in the aim of the study concerning three diseases: asthma, diabetes, and cancer. By including clinicians and adolescents is an effective way, the app developers can come up with efficient and evidence-based apps.
Credibility
Journal Publishing
This research article is found in a peer-reviewed Journal. On searching the heading of the article on Google Scholar, it redirects to the Journal of Medical Internet Research.
Design and Research Question
The research questions for the study are not provided. However, the systematic review used addresses the aim of the study, which is to analyze the effectiveness of the apps among adolescents with chronic physical illnesses.
Data Collection, Analysis, and Research Question
The data obtained from the four research articles and the analysis using the IBM Corp addressed the aim of the study. The authors could identify the effectiveness of the apps due to the involvement of adolescents and clinicians.
Choice of Articles and their Influence on the Findings
The exclusion criteria for the articles could have influenced the findings. The authors focused on the articles that were published in English and neglected other articles. Since mobile phone technology is not limited to English speaking countries alone, the exclusion criteria could have influenced the results.
Measuring Instruments and their Validity
The tools that were used to come up with the four articles were valid and reliable. The tool that was based on the data extraction template from Cochrane reviews prevented valuable information from being overlooked. Additionally, the use of Effective Public Health Practice Project assessment tool to assess the quality of evidence ensured examination of the relevant data only. Furthermore, the tool was used by a person who had expertise in it and thus, made it more reliable and valid for the study.
Control of Extraneous Variables and Potential Bias
Since both teams analyzed the studies independently, they could have had variations in their analysis techniques. However, the teams stayed in collaboration with each other, thus minimizing bias. Additionally, limiting the literature to English articles is an extraneous variable that could not be controlled.
Study Process and Influence on the Findings
The whole process of the study was collaborative and efficient. The use of various tools in analyzing the quality of the literature minimized any influences on the study findings.
Consistency of Research Findings
The research corresponds with other studies that associate the use of mobile technology with improved management of health conditions. For instance, Wyatt and Krauskopf (2012) carried out a study in which they found out that mobile phones are effective in the utilization of evidence-based practices.
Credibility of the Main Findings
First, the article states that the apps identified helped adolescents manage their health conditions. This finding is credible because the research also identified that there was involvement of clinicians and young people in coming up with the apps. The two main findings are relevant.
The discussion section is reliable since it addresses the main findings comprehensively and explains the way the apps are of interest to the adolescents. The discussion section further identifies that some apps are not based on evidence, which is true since most of the mobile app developers are entrepreneurs who are seeking profit. The discussion section also identifies the need for adolescents to improve their health-seeking behavior, which is relevant since the adolescents might focus on the apps and forget to seek expert advice. Finally, the study would be the same if conducted in the USA, because the literature used was from English-speaking countries and the USA uses English as a national language.
