RESUMO

This article demonstrates how digital information and communication technologies (ICTs) (Zoom/WhatsApp) unexpectedly and counterintuitively proved to be valuable tools for community-engaged health research when, in the context of the COVID-19 pandemic, they were integrated into a research study testing a peer support group intervention with female immigrants from Mexico. Because of pandemic restrictions, we changed the study protocol to hold meetings remotely via Zoom rather than in person as originally planned. Because we recognized that this would lack some opportunities for participants to interact and develop relationships, we created a WhatsApp chat for each group. Despite challenges for participants to use ICTs and participant-stated preference for in-person meetings, the results demonstrated that participants overwhelmingly endorsed these technologies as promoting access, participation, engagement, and satisfaction. Zoom/WhatsApp created a valuable environment both as a method for conducting research with this population, but also as part of the intervention for immigrant women to support and learn from each other. ICT adaptations have now permanently changed the way we conduct community-engaged health research.

RESUMO

Arboviral diseases remain a significant health concern worldwide, with over half the world's population at risk for dengue alone. Without a vaccine or targeted treatment, the most effective strategy of prevention is vector management with community involvement. mHealth interventions, like WhatsApp, offer promising results for engaging communities and promoting healthier behaviors. This study explores the feasibility of integrating WhatsApp in vector control activities to improve arbovirus prevention in Colombia. A mixed-methods approach was employed to assess the WhatsApp-based intervention. WhatsApp messages were sent to 45 community women for 5 weeks to increase their knowledge and practices about dengue, Zika, and chikungunya. Pre-and-post surveys and focus group discussions were conducted in community settings to measure the feasibility and acceptability of this intervention. Chat reviews were done to assess the usability of users. A total of 1566 messages were exchanged in 45 WhatsApp chats. High acceptance and good usability (82% of users used the app for replying) were reported in this study. WhatsApp messages were perceived as short, clear, and enjoyable. Users liked the frequency, and design of messages. Pre- and post-surveys demonstrated improvements in the knowledge and practices of arboviral diseases. The intention to apply this knowledge in practice was reflected in a significant improvement, particularly in cleaning the laundry tank once a week (pre 62.1% to post 89.6%, p < 0.008). This study suggests that using WhatsApp as an additional tool could be a feasible, acceptable, and affordable strategy for improving the adoption of better practices in the prevention of arboviral diseases.

Assuntos

RESUMO

Although the effectiveness of cardiac rehabilitation (CR) programs in secondary prevention is well-recognized, there is a lack of studies exploring the potential of mobile health to enhance educational interventions within CR. The objective is to assess the impact of a structured WhatsApp-assisted health educational intervention, in conjunction with the usual care, compared to the usual care alone among participants enrolled in a CR program. The trial will recruit 32 participants enrolled in a CR program, who will be randomly assigned to a structured WhatsApp-assisted health educational intervention plus usual care or usual care alone group. The intervention will span 4 weeks, with assessments at baseline, 4 weeks, and 3, 6, and 12 months. The primary outcome measure is the cardiovascular risk factors knowledge score. Secondary outcomes include physical activity levels, anxiety and depression, and quality of life. Expected results include improved knowledge of cardiovascular risk factors, increased physical activity levels, and better mental health outcomes in the intervention group. Additionally, an enhancement in the overall quality of life is anticipated. These findings are expected to underscore the value of integrating mHealth with traditional CR methods, potentially shaping future approaches in chronic disease management and prevention.

RESUMO

BACKGROUND: Stunting and micronutrient deficiencies have persistently affected children in the Brazilian Amazon for decades. However, in recent years, a notable increase in childhood overweight prevalence has been observed, particularly in the context of heightened food insecurity exacerbated by the COVID-19 pandemic. Despite the limited number of effective solutions proposed to tackle this problem, digital interventions have shown great promise worldwide in preventing obesity and promoting healthy diets. OBJECTIVE: This study aims to describe the protocol of a family-based WhatsApp intervention, specifically designed to investigate the efficacy of multimedia messaging in preventing excessive weight gain and improving healthy eating practices among school-aged children in the Amazon region. METHODS: This study protocol outlines a theory-driven randomized controlled trial based on the cognitive theory of multimedia learning and the social cognitive theory. A total of 240 parents or caregivers of children enrolled in the Maternal and Child Health and Nutrition Cohort Study in Acre (MINA-Brazil) will be recruited by phone and social media. The intervention group will receive persuasive multimedia messages through WhatsApp over 19 weeks, while the waitlist control group will remain in the usual care. The primary outcome is a change in children's BMI in z score. Secondary outcomes are changes in dietary intake and biochemical indicators of the children. Outcome measures will be assessed at baseline and 5 months after randomization in comparison to usual care. The analysis will use an intent-to-treat approach and will be conducted using the statistical package Stata (version 18.0), with a significance level set at P<.05. Paired and unpaired 2-tailed t tests will be applied to compare mean changes in the outcomes. RESULTS: Data collection started in June 2023, and final measurements are scheduled to be completed in December 2023. The results of the main analysis are expected to be available in 2024. CONCLUSIONS: This innovative multimedia message intervention holds significant potential for fostering behavioral changes among Amazonian children. TRIAL REGISTRATION: Brazilian Clinical Trials Registry RBR-5zdnw6t; https://ensaiosclinicos.gov.br/rg/RBR-5zdnw6t. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/54446.

RESUMO

Heart Failure (HF) has been ide.epsied as an important public health problem, with high morbidity and mortality, despite advances in current therapy. New strategies are demanded to reduce the number of hospitalizations and deaths. Telemedicine approaches could improve the management of patients with cardiovascular conditions. Sixty patients with heart failure with reduced ejection fraction (HFrEF) were randomized to this pilot study. Weekly electronic messages were sent for 1 year. The use of telemedicine was effective instrument for the evolutionary follow-up of patients with HFrEF during the COVID-19 pandemic, but did not demonstrate an impact on the reduction of cardiovascular outcomes or hospitalization for HF. REBEC - Brazilian Registry of Clinical Trials ide.epsier RBR-5q6x56k. Monitoring heart disease patients via WhatsApp during the COVID-19 pandemic. Available from http://www.ensaiosclinicos.gov.br/rg/RBR-5q6x56k/.

RESUMO

Resumo Diferentes análises sobre a participação política de evangélicas(os) pentecostais no Brasil nos últimos anos têm chamado a atenção para transformações causadas pelos usos de mídias digitais por estes grupos. Em busca de ampliar este debate a partir de elementos que compõem usos cotidianos de grupos de oração no WhatsApp, o objetivo deste artigo é compreender como as disputas engajadas por mulheres pentecostais têm ressignificado suas carreiras pastorais e formado novas coletividades evangélicas. Com a emergência de outros modos de viver as intimidades propiciadas por dispositivos móveis, reflito sobre relações religiosas estabelecidas através de imagens e sons em grupos de WhatsApp, além dos impactos digitais nas dinâmicas de autoridade religiosa feminina e sua expansão transnacional.

Resumen Diferentes análisis sobre la participación política de los evangélicos pentecostales en Brasil en los últimos años han llamado la atención sobre las transformaciones provocadas por el uso de medios digitales por parte de estos grupos. Buscando ampliar este debate a partir de elementos que componen el uso cotidiano de los grupos de oración en WhatsApp, busqué comprender cómo las disputas libradas por las mujeres pentecostales han resignificado sus carreras pastorales y conformado nuevas colectividades evangélicas. Con el surgimiento de otras formas de experimentar las intimidades que brindan los dispositivos móviles, reflexiono sobre las relaciones religiosas que se establecen a través de imágenes y sonidos en los grupos de WhatsApp, además del impacto digital en la dinámica de la autoridad religiosa femenina y su expansión transnacional.

Abstract Recent literature on the political participation of Pentecostal evangelicals in Brazil has drawn attention to the transformations caused by their use of digital media. To broaden this debate, in this article I describe the everyday use of the WhatsApp instant messaging program by prayer groups, shedding light on how disputes engaged by Pentecostal women have re-signified their pastoral careers and formed new evangelical collectivities. With the emergence of other ways of experiencing the intimacy provided by mobile devices, I reflect on religious connections established across images and sounds in WhatsApp groups, in addition to the digital impact on the dynamics of female religious authority and its transnational expansion.

Assuntos

RESUMO

Introducción: La pandemia COVID-19, causada por el virus SARS-CoV-2, y su exponencial crecimiento y migración a todos los continentes del globo terráqueo, provocaron una parálisis en el proceso de enseñanza-aprendizaje en las instituciones que no contaban con infraestructura en línea para el desarrollo de las actividades docentes de manera virtual. Objetivo: Exponer los retos, las soluciones y los aprendizajes que formaron parte del proceso para preservar las discusiones de casos clínicos en grupos pequeños de estudiantes durante las fases de cuarentena obligatoria de la pandemia en Sudáfrica. Métodos: Se aplicaron las fases de la investigación-acción adaptadas a las prácticas educacionales. En su ejecución participaron los 103 estudiantes del segundo año del grado de bachiller en Medicina y Cirugía, y sus 10 tutores. El módulo de Neurociencias fue el contexto educativo en el período comprendido entre abril y julio de 2020. Resultados: Se crearon chats de comunicación entre los actores del proceso. El módulo se prolongó en duración, y flexibilizó la frecuencia y el horario de las tutorías. Se redujo el número de secciones a develar de los casos y en cada una se introdujeron tareas que guiaron a aplicar contenidos derivados de los objetivos de aprendizaje. Se escogió la aplicación WhatsApp como la plataforma donde se realizarían las sesiones de tutoría. Conclusiones: El desplazamiento del aprendizaje colaborativo de las tutorías a la aplicación WhatsApp convirtió a esta plataforma en un aula virtual accesible en áreas de pobre conectividad. Los reajustes en la extensión y duración de los casos, y las nuevas tareas en sus secciones, se adaptaron a un proceso de asimilación más lento y con más opciones de mediación. Múltiples y variados resultaron los aprendizajes para los actores del proceso; vale destacar el humano y el tecnológico.

ABSTRACT Introduction: The COVID-19 pandemic, caused by the coronavirus SARS-CoV-2, as well as its exponential growth and migration to all continents of the globe, caused a paralysis in the teaching-learning process in institutions that did not have online infrastructure for the development of virtual teaching activities. Objective: To expose the challenges, solutions and learning that were part of the process for preserving clinical case discussions in small groups of students during the mandatory quarantine phases of the pandemic in South Africa. Methods: Action research phases adapted to educational practices were applied. All 103 second-year Bachelor of Medicine and Surgery students and their ten tutors participated in its execution. The Neurosciences module was the educational context in the period from April to July 2020. Results: Communication chats were created between the actors of the process. The module was extended in length, and the frequency and schedule of tutoring sessions was made more flexible. The number of sections to be unveiled from the cases was reduced; each section included guiding tasks for applying contents derived from the learning objectives. The WhatsApp application was chosen as the platform where the tutoring sessions would take place. Conclusions: The shift of collaborative learning from tutorials to the WhatsApp application turned this platform into a virtual classroom accessible in areas of poor connectivity. The length readjustments in the cases, as well as the new tasks in their sections, were adapted to a slower assimilation process and with more mediation options. There were multiple and varied learning experiences for the actors in the process; it is worth highlighting the human and technological aspects.

Assuntos

RESUMO

BACKGROUND: Despite unprecedented advances in worldwide access to the internet via smartphones, barriers to engaging hard-to-reach populations remain in many methods of health research. A potential avenue for conducting qualitative research is via participatory web-based media, including the free, popular social platform WhatsApp. However, despite the clear advantages of engaging with participants over a well-established web-based platform, logistical challenges remain. OBJECTIVE: This study aims to report evidence on the feasibility and acceptability of WhatsApp as a method to conduct focus groups. METHODS: A pilot focus group was conducted with Spanish-speaking women near the US-Mexico border. The content focus was knowledge and perceived risks for exposure to the Zika virus during pregnancy. RESULTS: Evidence was obtained regarding WhatsApp as a low-cost, logistically feasible methodology that resulted in rich qualitative data from a population that is often reticent to engage in traditional research. A total of 5 participants participated in a focus group, of whom all 5 consistently contributed to the focus group chat in WhatsApp, which was conducted over 3 consecutive days. CONCLUSIONS: The findings are noteworthy at a time when face-to-face focus groups, the gold standard, are risky or precluded by safe COVID-19 guidelines. Other implications include more applications and evaluations of WhatsApp for delivering one-on-one or group health education interventions on sensitive topics. This paper outlines the key steps and considerations for the replication or adaptation of methods.

RESUMO

Participatory learning and action cycles with women's groups have been recommended by the WHO to promote maternal and newborn health, but few studies have tested its feasibility and acceptability in mobile health (mHealth) interventions among mothers of toddlers. This was a mixed-method feasibility assessment of an 8-week WhatsApp-based maternal support group for mothers of toddlers (12-18 months of age) enrolled in a birth cohort study in Southern Brazil. Daily messages and weekly activities were sent by moderators to promote maternal-child outcomes: child nutrition, child sleep, nurturing care, and maternal psychosocial well-being (assessed pre- and post-intervention via self-reported questionnaire). The implementation and engagement of the mothers in the program were assessed by message extraction. Acceptability was evaluated through in-depth interviews (n = 5) and open-ended surveys (n = 10). 1481 messages were exchanged in 3 WhatsApp groups (n = 30 mothers). Mothers were most active on weekdays (68.6% of messages sent on Tuesdays and 72.6% on Thursdays), afternoons (2:00-4:00pm), and evenings (9:00-11:00 pm). Engagement was higher at weeks 1-4. Mothers enjoyed and considered topics relevant. Group interaction was perceived as low, which influenced their participation. The prevalence of depression symptoms decreased from pre- to post-intervention (9% to 5%; P = .04). A moderated mobile-based support group for mothers of toddlers was feasible. mHealth services to promote maternal support are a promising strategy to improve maternal-child outcomes, but engagement and use of the service remains a challenge. Program managers should work with community members to identify ways to support engagement and participation throughout the intervention.

Assuntos

RESUMO

BACKGROUND: Patients with chronic urticaria (CU) are increasingly using information and communication technologies (ICTs) to manage their health. What CU patients expect from ICTs and which ICTs they prefer remains unknown. We assessed why CU patients use ICTs, which ones they prefer, and what drives their expectations and choices. METHODS: In this cross-sectional study, 1841 patients across 17 countries were recruited at UCAREs (Urticaria Centers of Reference and Excellence). Patients with CU who were >12 years old completed a 23-item questionnaire. RESULTS: Most patients were interested in receiving disease information (87.3%), asking physicians about CU (84.1%), and communicating with other patients through ICTs (65.6%). For receiving disease information, patients preferred one-to-one and one-to-many ICTs, especially web browsers. One-to-one ICTs were also the ICTs of choice for asking physicians about urticaria and for communicating with other patients, and e-mail and WhatsApp were the preferred ICTs, respectively. Many-to-many ICTs such as Facebook, Instagram, LinkedIn, and Twitter were least preferred for all 3 purposes. Living in rural areas and higher education were linked to higher odds of being interested in receiving disease information, asking physicians, and communicating with patients through ICTs. CONCLUSIONS: Most patients and especially patients with higher education who live in rural areas are interested in using ICTs for their healthcare, but prefer different ICTs for different purposes, ie, web browsers for obtaining information, e-mail for asking physicians, and WhatsApp for communicating with other patients. Our findings may help to improve ICTs for CU.