Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Apr 24, 2019
Open Peer Review Period: Apr 29, 2019 - May 28, 2019
Date Accepted: Jul 21, 2019
(closed for review but you can still tweet)
Impact of the iMHere Mobile Health System on Health and Psychosocial Outcomes in Spinal Cord Injury: A Randomized Controlled Trial
ABSTRACT
Background:
Individuals with spinal cord injury (SCI) are at risk for secondary medical complications, such as urinary tract infections (UTIs) and pressure injuries that could potentially be mitigated through improved self-management techniques. The Interactive Mobile Health and Rehabilitation (iMHere) mobile health system was developed for individuals with disabilities to support self-management.
Objective:
The main objective of this study was to determine if the use of iMHere would be associated with improved health outcomes over a 9-month period. A secondary objective was to determine if use of iMHere would be associated with improved psychosocial outcomes. Phone usage, app usage and training time data were also collected to analyze trends in iMHere use.
Methods:
Thirty-eight participants with SCI were randomized into either the intervention group who used the iMHere system and received standard care, or the control group who received standard care without any technology intervention. Health outcomes were recorded for the year prior to entry into the study, and during the 9 months of the study. Participants completed surveys at baseline and every three months to measure psychosocial outcomes.
Results:
The intervention group had a statistically significant reduction in UTIs (0.47 events per person, P = 0.03, Number needed to treat= 2.11). While no psychosocial outcomes changed significantly, there was a non-significant trend toward a reduction in mood symptoms in the intervention group compared to control, meeting threshold for clinical significance. Approximately 34 minutes per participant per month were needed on average to manage the system and provide technical support through this mobile health system.
Conclusions:
The use of the iMHere mobile health system may be a valuable tool in the prevention of UTIs or reductions in depressive symptoms. Given these findings, iMHere has potential scalability for larger populations. Clinical Trial: ClinicalTrials.gov, registration # NCT02592291
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