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      Mindfulness-Based Symptom and Stress Management Apps for Adults With Chronic Lung Disease: Systematic Search in App Stores

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          Abstract

          Background

          Up to 70% of lung cancer survivors are affected by chronic obstructive pulmonary disease (COPD), a common, debilitating, comorbid disease. Lung cancer and COPD are both characterized by symptoms such as breathlessness, fatigue, and psychological distress. These distressing chronic symptoms are exacerbated by stress and detract from an individual’s quality of life.

          Objective

          The aim of this study was to identify and evaluate evidence-based, commercially available apps for promoting mindfulness-based strategies among adults with a COPD or lung cancer history (ie, chronic lung disease).

          Methods

          For this review, an interdisciplinary research team used 19 keyword combinations in the search engines of Google and iOS app stores in May 2017. Evaluations were conducted on the apps’ (1) content, (2) usability heuristics, (3) grade-level readability, and (4) cultural sensitivity.

          Results

          The search resulted in 768 apps (508 in iOS and 260 in Google stores). A total of 9 apps met the inclusion criteria and received further evaluation. Only 1 app had below an eighth-grade reading level; the ninth one did not have enough text to calculate a readability score. None of the 9 apps met the cultural sensitivity evaluation criteria.

          Conclusions

          This systematic review identified critical design flaws that may affect the ease of using the apps in this study. Few mobile apps promote mindfulness-based strategies among adults with chronic lung disease (ie, COPD or lung cancer or both), but those that exist, overall, do not meet the latest scientific evidence. Recommendations include more stringent regulation of health-related apps, use of evidence-based frameworks and participatory design processes, following evidence-based usability practices, use of culturally sensitive language and images, and ensuring that content is written in plain language.

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          Most cited references29

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          Community-based participatory research: policy recommendations for promoting a partnership approach in health research.

          Community-based participatory research in public health focuses on social, structural, and physical environmental inequities through active involvement of community members, organizational representatives, and researchers in all aspects of the research process. Partners contribute their expertise to enhance understanding of a given phenomenon and integrate the knowledge gained with action to benefit the community involved. This article presents key principles of community-based participatory research (CBPR), discusses the rationale for its use, and provides a number of policy recommendations at the organizational, community and national levels aimed at advancing the application of CBPR. While the issues addressed here draw primarily upon experiences in the United States, the emphasis throughout this article on the establishment of policies to enhance equity that would serve both to increase the engagement of communities as partners in health research, and to reduce health disparities, has relevant applications in a global context.
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            Mechanistic links between COPD and lung cancer.

            Numerous epidemiological studies have consistently linked the presence of chronic obstructive pulmonary disease (COPD) to the development of lung cancer, independently of cigarette smoking dosage. The mechanistic explanation for this remains poorly understood. Progress towards uncovering this link has been hampered by the heterogeneous nature of the two disorders: each is characterized by multiple sub-phenotypes of disease. In this Review, I discuss the nature of the link between the two diseases and consider specific mechanisms that operate in both COPD and lung cancer, some of which might represent either chemopreventive or chemotherapeutic targets.
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              The relationship between COPD and lung cancer

              Highlights • COPD is a risk factor for lung cancer beyond their shared aetiology. • Both are driven by oxidative stress. • Both are linked to cellular aging, senescence and telomere shortening. • Both have been linked to genetic predisposition. • Both show altered epigenetic regulation of gene expression.
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                Author and article information

                Contributors
                Journal
                JMIR Mhealth Uhealth
                JMIR Mhealth Uhealth
                JMU
                JMIR mHealth and uHealth
                JMIR Publications (Toronto, Canada )
                2291-5222
                May 2018
                15 May 2018
                : 6
                : 5
                : e124
                Affiliations
                [1] 1 College of Social Work University of South Carolina Columbia, SC United States
                [2] 2 College of Public Health University of Georgia Athens, GA United States
                [3] 3 School of Social Work University of Georgia Athens, GA United States
                [4] 4 Department of Health Promotion Education and Behavior University of South Carolina Columbia, SC United States
                [5] 5 College of Nursing University of South Carolina Columbia, SC United States
                Author notes
                Corresponding Author: Otis L Owens owenso@ 123456mailbox.sc.edu
                Author information
                http://orcid.org/0000-0002-1023-1449
                http://orcid.org/0000-0002-6834-6978
                http://orcid.org/0000-0001-5492-3562
                http://orcid.org/0000-0002-7279-1660
                http://orcid.org/0000-0002-7523-2004
                http://orcid.org/0000-0001-8418-4414
                Article
                v6i5e124
                10.2196/mhealth.9831
                5974462
                29764800
                d00c90ca-49f3-4e76-b0a4-7a2e91d57358
                ©Otis L Owens, Jenay M Beer, Ligia I Reyes, David G Gallerani, Amanda R Myhren-Bennett, Karen K McDonnell. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 15.05.2018.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR mhealth and uhealth, is properly cited. The complete bibliographic information, a link to the original publication on http://mhealth.jmir.org/, as well as this copyright and license information must be included.

                History
                : 12 January 2018
                : 28 February 2018
                : 2 April 2018
                : 3 April 2018
                Categories
                Review
                Review

                mindfulness,lung neoplasms,chronic obstructive pulmonary disease,mobile apps,review

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