A development and evaluation process for mHealth interventions: examples from New Zealand

The authors established a process for the development and testing of mobile phone-based health interventions that has been implemented in several mHealth interventions developed in New Zealand. This process involves a series of steps: conceptualization, formative research to inform the development, pretesting content, pilot study, pragmatic randomized controlled trial, and further qualitative research to inform improvement or implementation. Several themes underlie the entire process, including the integrity of the underlying behavior change theory, allowing for improvements on the basis of participant feedback, and a focus on implementation from the start. The strengths of this process are the involvement of the target audience in the development stages and the use of rigorous research methods to determine effectiveness. The limitations include the time required and potentially a less formalized and randomized approach than some other processes. This article aims to describe the steps and themes in the mHealth development process, using the examples of a mobile phone video messaging smoking cessation intervention and a mobile phone multimedia messaging depression prevention intervention, to stimulate discussion on these and other potential methods.

A mHealth cardiac rehabilitation exercise intervention: findings from content development studies

BACKGROUND: Involving stakeholders and consumers throughout the content and study design ensures interventions are engaging and relevant for end-users. The aim of this paper is to present the content development process for a mHealth (mobile phone and internet-based) cardiac rehabilitation (CR) exercise intervention.

METHODS: An innovative mHealth intervention was developed with patient input using the following steps: conceptualization, formative research, pre-testing, and pilot testing. Conceptualization, including theoretical and technical aspects, was undertaken by experts. For the formative component, focus groups and interviews with cardiac patients were conducted to discuss their perceptions of a mHealth CR program. A general inductive thematic approach identified common themes. A preliminary library of text and video messages were then developed. Participants were recruited from CR education sessions to pre-test and provide feedback on the content using an online survey. Common responses were extracted and compiled. An iterative process was used to refine content prior to pilot testing and conduct of a randomized controlled trial.

RESULTS: 38 CR patients and 3 CR nurses participated in the formative research and 20 CR patients participated in the content pre-testing. Participants perceived the mHealth program as an effective approach to inform and motivate patients to exercise. For the qualitative study, 100% (n = 41) of participants thought it to be a good idea, and 11% of participants felt it might not be useful for them, but would be for others. Of the 20 participants who completed the online survey, 17 out of 20 (85%) stated they would sign up to a program where they could receive information by video messages on a website, and 12 out of 20 (60%) showed interest in a texting program. Some older CR patients viewed technology as a potential barrier as they were unfamiliar with text messaging or did not have mobile phones. Steps to instruct participants to receive texts and view the website were written into the study protocol. Suggestions to improve videos and wording of texts were fed back to the content development team and refined.

CONCLUSIONS: Most participants thought a mHealth exercise program was an effective way to deliver exercise-based CR. The results were used to develop an innovative multimedia exercise intervention. A randomized controlled trial is currently underway.

Video testimony : the generation and transmission of trauma

My mother experienced the final part of the Second World War displaced and separated from her family and particularily her husband. (His name was on Oscar Schindler's List; her name was, and then wasn't). This dislocation from her husband was one trauma within a larger set of daily traumas. In 1997, as part of the Shoah Foundation Visual History series, my mother narrated her individualized video testimony, once again, separated from her family. This paper examines the methodologies of this video testimony in relation to two connected questions: was my mother re-traumatized by the process of providing her testemony, and by narrating and recording her video testimony, did she, unwittingly, 'transmit' her traumas, and those of her generation to my generation?

Video indexing by spatial representation

Recent approaches to video indexing and retrieval are either pixel-oriented or object-oriented. While the former approaches focus on motion and changes thereto, the latter focus on spatial relations among objects in the scene. In this paper, a spatial knowledge representation technique combining both approaches is proposed. This representation supplements the spatial knowledge of visual objects with information about their pixel positions in the video frame. It provides a practical way to construct video indices, enabling searching for and retrieval of video sequences that contain motion as well as sparsely disjoint objects

From video recordings to whisker stable isotopes: a critical evaluation of timescale in assessing individual foraging specialisation in Australian fur seals

Estimating the degree of individual specialisation is likely to be sensitive to the methods used, as they record individuals' resource use over different time-periods. We combined animal-borne video cameras, GPS/TDR loggers and stable isotope values of plasma, red cells and sub-sampled whiskers to investigate individual foraging specialisation in female Australian fur seals (Arctocephalus pusillus doriferus) over various timescales. Combining these methods enabled us to (1) provide quantitative information on individuals' diet, allowing the identification of prey, (2) infer the temporal consistency of individual specialisation, and (3) assess how different methods and timescales affect our estimation of the degree of specialisation. Short-term inter-individual variation in diet was observed in the video data (mean pairwise overlap = 0.60), with the sampled population being composed of both generalist and specialist individuals (nested network). However, the brevity of the temporal window is likely to artificially increase the level of specialisation by not recording the entire diet of seals. Indeed, the correlation in isotopic values was tighter between the red cells and whiskers (mid- to long-term foraging ecology) than between plasma and red cells (short- to mid-term) (R (2) = 0.93-0.73 vs. 0.55-0.41). δ(13)C and δ(15)N values of whiskers confirmed the temporal consistency of individual specialisation. Variation in isotopic niche was consistent across seasons and years, indicating long-term habitat (WIC/TNW = 0.28) and dietary (WIC/TNW = 0.39) specialisation. The results also highlight time-averaging issues (under-estimation of the degree of specialisation) when calculating individual specialisation indices over long time-periods, so that no single timescale may provide a complete and accurate picture, emphasising the benefits of using complementary methods.

Enabling electronic medicine at Kiwicare : the case of video conferencing adoption for psychiatry in New Zealand

Telemedicine emerges as a viable solution to New Zealand health providers in reaching out to rural patients, in offering medical services and conducting administrative meetings and training. No research exists about adoption of telemedicine in New Zealand. The purpose of this case study was to explain factors influencing adoption of telemedicine utilizing video conferencing technology (TMVC) within a New Zealand hospital known as KiwiCare. Since TMVC is part of IT, tackling it from within technological innovation literature may assist in providing an insight into its adoption within KiwiCare and into the literature. Findings indicate weak presence of critical assessment into technological innovation factors prior to the adoption decision, thereby leading to its weak utilization. Factors like complexity, compatibility and trialability were not assessed extensively by KiwiCare and would have hindered TMVC adoption. TMVC was mainly assessed according to its relative advantage and to its cost effectiveness along with other facilitating and accelerating factors. This is essential but should be alongside technological and other influencing factors highlighted in the literature.

Strategies to develop divided attention skills through video game training

Research .over the past two decades has confirmed the learning opportunities that video games can offer. The objectives of the current study were to investigate the ability of video games to enhance divided attention skills and compare these skills based on individuals' level of expertise in video game playing. Female participants aged between 17-25 years categorised as experts or novices, were divided into experimental and control groups. All participants completed the pre and post-test of divided attention between which only the experimental group received video game training. Results indicate that participants who received video game practice achieved an increase in their dual-attention skills compared to those who did not receive any training, with novices displaying a greater
enhancement in perfonnance. Implications include the provision of video game training to enhance divided attention skills in air pilot training, driving, and heavyequipment operation apart from other tasks necessitating dual-task efficiency.

Integrating highlights for more complete sports video summarization

Summarization is an essential requirement for achieving a more compact and interesting representation of sports video contents. We propose a framework that integrates highlights into play segments and reveal why we should still retain breaks. Experimental results show that fast detections of whistle sounds, crowd excitement, and text boxes can complement existing techniques for play-breaks and highlights localization.

Using object and trajectory analysis to facilitate indexing and retrieval of video

This paper aims to show that by using low level feature extraction, motion and object identifying and tracking methods, features can be extracted and indexed for efficient and effective retrieval for video; such as an awards ceremony video. Video scene/shot analysis and key frame extraction are used as a foundation to identify objects in video and be able to find spatial relationships within the video. The compounding of low level features such as colour, texture and abstract object identification lead into higher level real object identification and tracking and scene detection. The main focus is on using a video style that is different to the heavily used sports and news genres. Using different video styles can open the door to creating methods that could encompass all video types instead of specialized methods for each specific style of video.

Championing telemedicine in New Zealand : the case of utilizing video conferencing in psychiatry and dermatology

This research explores the factors that could influence telemedicine success in two hospitals involved in a rural setting in New Zealand. Findings from the cases revealed that telemedicine utilising the video conferencing technology (TMVC) was adopted based on its cost-benefit to the hospitals. This is necessary but considering the impact of other factors, specifically the compatibility factor could have made the adoption decision more effective earlier on. The administration manager was the primary instigator of TMVC in psychiatry in one of the hospitals, whereas in the other hospital it was the dermatologist. Therefore, this research emphasises the importance of the tight coupling between the roles of both the management and the clinical champions for TMVC to succeed in New Zealand. However, the research results suggest the limited use of the technology in the cases.

A simulation model for video traffic performance via ATM over TCP/IP

Although TCP has emerged as the standard in data communication, the introduction of ATM technology has raised numerous problems regarding the effectiveness of using TCP over A TM networks, especially when video traffic performance is considered. This paper presents a simulation model for transmission performance of video traffic via ATM over TCP/IP. The interactivity between TCP/IP and ATM, generation of MPEG traffic and evaluation of traffic performance are implemented in the model. The design and implementation details of the model are carefully described. The experiments conducted using the model and experimental results are briefly introduced, revealing the capability of our model in simulating network events and in evaluating potential solutions to performance issues.

Reducing blocking artefacts in MPEG video coded images using entropic methods

In this paper investigation is made of the. use of entropic methods to identify smooth image blocks in order to filter the reconstructed image of block based transform coded images. We know that blocking artefact is Visually more prominent in the smooth region of a block rather than in the textured region. The entropic methods are employed to distinguish between smooth and textured blocks in a reconstructed image. The linear filtering is then carried out on the smooth region of the image to reduce the blocking artefact. The en tropic criteria investigated in this paper are: Shannon's (Logarithmic) Entropy, Exponential Entropy, and Quadratic Entropy.

Recording the past to prepare for the future : the role of the teaching portfolio

This paper discusses the role of the portfolio in relation to teaching in the higher education sector. As well as evidencing experience and achievements it is argued that the portfolio can be an important tool to support reflection and increased understanding. Underpinned by relevant scholarly literature, the paper draws on the practice of using portfolios as part of the Induction Programme for new staff at Deakin University since 2001 and for promotion since 2002 as well as a trial of electronic portfolios. Commencing with indicators of the level of interest in portfolios, the author characterises teaching portfolios and explains why they are used from both an individual and institutional point of view. The theoretical basis for portfolios and the experience elsewhere are set alongside the practice at Deakin as the author explores some of the challenges for those who prepare and assess portfolios.