Browsing by Author "Heleno, Bruno"
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- Do smartphone applications and activity trackers increase physical activity in adults? Systematic review, meta-analysis and metaregressionPublication . Laranjo, Liliana; Ding, Ding; Heleno, Bruno; Kocaballi, A. Baki; Quiroz, Juan-Carlos; Tong, Huong Ly; Chahwan, Bahia; Neves, Ana Luisa; Gabarron, Elia; Dao, Kim Phuong; Rodrigues, David; Neves, Gisela Costa; Antunes, Maria L; Coiera, Enrico; Bates, David WTo determine the effectiveness of physical activity interventions involving mobile applications (apps) or trackers with automated and continuous self-monitoring and feedback. Design Systematic review and meta-analysis. Data sources PubMed and seven additional databases, from 2007 to 2020. Study selection Randomised controlled trials in adults (18–65 years old) without chronic illness, testing a mobile app or an activity tracker, with any comparison, where the main outcome was a physical activity measure. Independent screening was conducted. Data extraction and synthesis We conducted random effects meta-analysis and all effect sizes were transformed into standardised difference in means (SDM). We conducted exploratory metaregression with continuous and discrete moderators identified as statistically significant in subgroup analyses. Main outcome measures Physical activity: daily step counts, min/week of moderate-to- vigorous physical activity, weekly days exercised, min/week of total physical activity, metabolic equivalents. Results Thirty-five studies met inclusion criteria and 28 were included in the meta-analysis (n=7454 participants, 28% women). The meta-analysis showed a small-to- moderate positive effect on physical activity measures (SDM 0.350, 95% CI 0.236 to 0.465, I2=69%, T2=0.051) corresponding to 1850 steps per day (95% CI 1247 to 2457). Interventions including text-messaging and personalisation features were significantly more effective in subgroup analyses and metaregression. Conclusion Interventions using apps or trackers seem to be effective in promoting physical activity. Longer studies are needed to assess the impact of different intervention components on long-term engagement and effectiveness.
- Factors associated with cervical cancer screening among migrant women in Europe: a systematic scoping review protocolPublication . Marques, Patrícia; Nunes, Mariana; Antunes, Maria da Luz; Heleno, Bruno; Dias, SóniaCervical cancer is the 4th most common cancer in women in Europe. Cervical cancer screening (CCS) reduces its incidence and mortality, but its effectiveness relies on the quality of screening and women's participation. Migrant women show low participation in CCS, which might compromise an early diagnosis of the disease. Since migration rates are high in Europe, it is important to understand which barriers and facilitators influence participation in CCS among migrants to develop strategies to increase their participation. The main objective of this study is to analyze existing evidence about the factors associated with CCS participation among migrant women in Europe,
- Factors associated with cervical cancer screening participation among migrant women in Europe: a scoping reviewPublication . Marques, Patrícia; Nunes, Mariana; Antunes, Maria Da Luz; Heleno, Bruno; Dias, SoniaCervical cancer screening has been effective in reducing incidence and mortality of cervical cancer, leading European countries to implement screening programs. However, migrant women show lower screening participation compared to nationals. This scoping review aims to provide a synthesis of the growing evidence on factors associated with participation in cervical cancer screening among migrant women in Europe.
- Portuguese primary care physicians response rate in surveys: A systematic reviewPublication . Basílio, Nuno; Cardoso, Sara; Nunes, José Mendes; Laranjo, Liliana; Antunes, Maria da Luz; Heleno, BrunoIntroduction: Surveys are a useful tool in primary care. However, low response rates can introduce selection bias, impairing both external and internal validity. The aim of this study was to assess the average response rate in surveys with Portuguese general practitioners (GPs). Method: We searched the Medline, Web of Science, Scopus, Embase, PsychInfo, SciELO, IndexRMP, RCAAP, Revista Portuguesa de Medicina Geral e Familiar, Acta Médica Portuguesa and the proceedings of conferences of general practice from incepton to December 2016. We included all postal, e-mail, telephone and personal surveys to primary care physicians without language restrictions. We did not assess risk of bias of included studies, since the main outcome was survey response rate. We performed planned subgroup analyses of the use of monetary incentives, the use of non-monetary incentives, survey delivery modes and prior contact with participants. Results: A total of 1,094 papers were identified and 37 studies were included in this review. The response rate in surveys done to Portuguese GPs was 56% (95CI 47-64%). There was substantial heterogeneity among included studies (I2=99%), but subgroup analysis did not explain this heterogeneity. Conclusion: Consistent with other published studies, the average response rate in surveys done with Portuguese GPs was 56%, with substantial variation among studies. Use of monetary incentives, one of the most effective strategies to increase response rates, was not present in any of the included studies.
- Primary care physicians' decision-making processes in the context of multimorbidity: protocol of a systematic review and thematic synthesis of qualitative researchPublication . Rodrigues, David Silvério; Sousa, Paulo Faria; Basílio, Nuno; Antunes, Ana; Antunes, Maria Da Luz; Santos, Maria Isabel; Heleno, BrunoGood patient outcomes correlate with the physicians' capacity for good clinical judgement. Multimorbidity is common and it increases uncertainty and complexity in the clinical encounter. However, healthcare systems and medical education are centred on individual diseases. In consequence, recognition of the patient as the centre of the decision-making process becomes even more difficult. Research in clinical reasoning and medical decision in a real-world context is needed. The aim of the present review is to identify and synthesise available qualitative evidence on primary care physicians' perspectives, views or experiences on decision-making with patients with multimorbidity.