American journal of preventive medicine
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Creative use of new mobile and wearable health information and sensing technologies (mHealth) has the potential to reduce the cost of health care and improve well-being in numerous ways. These applications are being developed in a variety of domains, but rigorous research is needed to examine the potential, as well as the challenges, of utilizing mobile technologies to improve health outcomes. Currently, evidence is sparse for the efficacy of mHealth. ⋯ The current paper presents the results of the workshop. Although the discussions at the meeting were cross-cutting, the areas covered can be categorized broadly into three areas: (1) evaluating assessments; (2) evaluating interventions; and (3) reshaping evidence generation using mHealth. This paper brings these concepts together to describe current evaluation standards, discuss future possibilities, and set a grand goal for the emerging field of mHealth research.
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Pragmatic measures are important to facilitate implementation and dissemination, address stakeholder issues, and drive quality improvement. This paper proposes necessary and recommended criteria for pragmatic measures, provides examples of projects to develop and identify such measures, addresses potential concerns about these recommendations, and identifies areas for future research and application. ⋯ There is an important need for pragmatic measures to facilitate pragmatic research, guide quality improvement, and inform progress on public health goals, but few examples are currently available. Development and evaluation of pragmatic measures and metrics would provide useful resources to advance science, policy, and practice.
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Walk Score® and Transit Score® are open-source measures of the neighborhood built environment to support walking ("walkability") and access to transportation. ⋯ Walk Score and Transit Score appear to be useful as measures of walkability in analyses of neighborhood effects.
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Bystander cardiopulmonary resuscitation (BCPR) provides an opportunity for decreasing cardiac mortality. Rates of out-of-hospital cardiac arrest (OHCA) in which resuscitation was performed vary within cities and across demographics. ⋯ Geospatial analysis can provide important information on the contiguous areas of high OHCA rates and low BCPR rates with the aim of more effectively targeting interventions and ultimately decreasing cardiac deaths.
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Federal law requires certain private insurers to cover and waive patient cost sharing for preventive medical services that receive a grade of B or better from the U.S. Preventive Services Task Force (USPSTF). The USPSTF recommends that asymptomatic adults who have a blood pressure (BP) higher than 135/80 mmHg be screened for type 2 diabetes. ⋯ The USPSTF screening recommendations result in missing more than half of those who have undiagnosed diabetes, and a substantial proportion of these people have increased low-density lipoprotein and other cardiovascular risk factors.