JMIR Human Factors最新文献

{"title":"Longitudinal and Combined Smartwatch and Ecological Momentary Assessment in Racially Diverse Older Adults: Feasibility, Adherence, and Acceptability Study.","authors":"Sophia Holmqvist, Marina Kaplan, Riya Chaturvedi, Haochang Shou, Tania Giovannetti","doi":"10.2196/69952","DOIUrl":"https://doi.org/10.2196/69952","url":null,"abstract":"<p><strong>Background: </strong>Due to the rising prevalence of Alzheimer disease and related dementias, easily deployable tools to quantify risk are needed. Smartphones and smartwatches enable unobtrusive and continuous monitoring, but there is limited information regarding the feasibility, adherence, and acceptability of digital data collection among racially diverse older adults.</p><p><strong>Objective: </strong>This paper examined the feasibility, adherence, and acceptability of a 4-week combined smartwatch monitoring and ecological momentary assessment (EMA) study in a racially diverse sample of older adults.</p><p><strong>Methods: </strong>A total of 44 older adults (aged ≥55 y) with either mild cognitive impairment or healthy cognition completed an informed consent comprehension quiz, baseline cognitive testing, training regarding digital data collection, and questionnaires. Participants were instructed to wear a Garmin Vivosmart 4 smartwatch for 23 h/d for 4 weeks, sync 2 smartphone apps (Garmin and Labfront) daily, and complete a daily EMA survey with automated prompts for surveys and charging. Training time, smartwatch adherence (eg, wear time), daily EMA survey response rate, and performance on the consent quiz were quantified. Associations between feasibility and adherence metrics and participant factors were evaluated. Self-reported usability of the apps and smartwatch was collected at study end.</p><p><strong>Results: </strong>Consent comprehension quiz scores were high (mean 97.33%, SD 6.86% correct), and training sessions lasted on average 17.93 (SD 6.89) minutes. During the 4-week study, participants wore the smartwatch for an average of 21 h/d (SD 1.53) and showed an average response rate of 94% (SD 9.58%) to daily EMA surveys. In unadjusted bivariate analyses, age, race, and cognition were associated with feasibility and adherence measures, but only age and race remained significant in multivariate models. After accounting for all participant factors, older age was a significant predictor of longer training time, and Black race was a significant predictor of lower daily wear time. On the usability survey, all participants (45/45, 100%) indicated willingness to participate in future smartwatch studies, >80% (37/45) had a positive experience, and >90% (41/45) were satisfied with smartphone app syncing.</p><p><strong>Conclusions: </strong>Smartwatch monitoring, requiring daily wear, smartphone syncing, and daily EMA survey completion, is highly feasible in older adults because adherence to daily wear and EMA surveys was high, as was general satisfaction on usability surveys. Although older participants may require more training on smartwatch and smartphone procedures and automated prompting during the study period, longitudinal monitoring with the Garmin Vivosmart 4 smartwatch and Labfront app is acceptable and feasible for collecting nearly continuous data in Black and White older adults, including those with mild cognitive impa","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"12 ","pages":"e69952"},"PeriodicalIF":2.6,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of Digital Strategies for Reducing Sedentary Behavior in a Hybrid Office Environment: Modified Delphi Study.","authors":"Iris Parés-Salomón, Cristina Vaqué-Crusellas, Alan Coffey, Bette Loef, Karin I Proper, Anna M Señé-Mir, Anna Puig-Ribera, Kieran P Dowd, Judit Bort-Roig","doi":"10.2196/59405","DOIUrl":"https://doi.org/10.2196/59405","url":null,"abstract":"<p><strong>Background: </strong>Hybrid work is the new modus operandi for many office workers, leading to more sedentary behavior than office-only working. Given the potential of digital interventions to reduce sedentary behavior and the current lack of studies evaluating these interventions for home office settings, it is crucial to develop digital interventions for such contexts involving all stakeholders.</p><p><strong>Objective: </strong>This study aimed to reach expert consensus on the most feasible work strategies and the most usable digital elements as a delivery method to reduce sedentary behavior in the home office context.</p><p><strong>Methods: </strong>A modified Delphi study including 3 survey rounds and focus groups was conducted to achieve consensus. The first Delphi round consisted of two 9-point Likert scales for assessing the feasibility of work strategies and the potential usefulness of digital elements to deliver the strategies. The work strategies were identified and selected from a scoping review, a systematic review, and 2 qualitative studies involving managers and employees. The median and mean absolute deviation from the median for each item are reported. The second round involved 2 ranking lists with the highly feasible strategies and highly useful digital elements based on round 1 responses to order the list according to experts' preferences. The weighted average ranking for each item was calculated to determine the most highly ranked work strategies and digital elements. The third round encompassed work strategies with a weight above the median from round 2 to be matched with the most useful digital elements to implement each strategy. In total, 4 focus groups were additionally conducted to gain a greater understanding of the findings from the Delphi phase. Focus groups were analyzed using the principles of reflexive thematic analysis.</p><p><strong>Results: </strong>A total of 27 international experts in the field of occupational health participated in the first round, with response rates of 86% (25/29) and 66% (19/29) in rounds 2 and 3, respectively, and 52% (15/29) in the focus groups. Consensus was achieved on 18 work strategies and 16 digital elements. Feedback on activity progress and goal achievement; creating an action plan; and standing while reading, answering phone calls, or conducting videoconferences were the most feasible work strategies, whereas wrist-based activity trackers, a combination of media, and app interfaces in smartphones were the most useful digital elements. Moreover, experts highlighted the requirement of combining multiple levels of strategies, such as social support, physical environment, and individual strategies, to enhance their implementation and effectiveness in reducing sedentary behavior when working from home.</p><p><strong>Conclusions: </strong>This expert consensus provided a foundation for developing digital interventions for sedentary behavior in home office workers. Ongoing i","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"12 ","pages":"e59405"},"PeriodicalIF":2.6,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Social Media Platforms to Raise Health Awareness and Increase Health Education in Pakistan: Structural Equation Modeling Analysis and Questionnaire Study.","authors":"Malik Mamoon Munir, Nabil Ahmed","doi":"10.2196/65745","DOIUrl":"https://doi.org/10.2196/65745","url":null,"abstract":"<p><strong>Background: </strong>Current health care education methods in Pakistan use traditional media (eg, television and radio), community health workers, and printed materials, which often fall short of reach and engagement among most of the population. The health care sector in Pakistan has not yet used social media effectively to raise awareness and provide education about diseases. Research on the impact social media can have on health care education in Pakistan may expand current efforts, engage a wider audience, and reduce the disease burden on health care facilities.</p><p><strong>Objective: </strong>This study aims to evaluate the perceptions of health care professionals and paramedic staff regarding social media use to raise awareness and educate people about diseases as a potential means of reducing the disease burden in Pakistan.</p><p><strong>Methods: </strong>The study used two-stage structural equation modeling (SEM). Data analysis used AMOS 26.0 software, adopting scales from previous literature. Four-item scales for each social media usefulness and health awareness construct and 8-item scales for health care education constructs were adopted on the basis of their higher loading in alignment with psychometric literature. A 7-point Likert scale was used to measure each item. Data collection used convenience sampling, with questionnaires distributed to more than 450 health care professionals and paramedic staff from 2 private hospitals in Lahore, Pakistan. There were 389 useful responses received. However, 340 completed questionnaires were included in the data analysis.</p><p><strong>Results: </strong>The study found that all the squared multiple correlation (SMC) values were greater than 0.30. Furthermore, convergent validity was measured using (1) standardized factor loading (found greater than 0.5), (2) average variance explained (found greater than 0.5), and (3) composite reliability (found greater than 0.7). The confirmatory factor analysis (CFA) of the measurement model indicated the fitness of the constructs (Chi-square minimum [CMIN]=357.62; CMIN/degrees of freedom [DF]=1.80; Goodness of Fit [GFI]=0.90; Adjusted Goodness of Fit Index [AGFI]=0.89; Buntler-Bonett Normed Fit Index [NFI]=0:915; Comparative Fit Index [CFI]=0:93; Root Mean Square Residual [RMR]=0:075; Root Mean Square Error of Approximation [RMSEA]=0:055). Moreover, the structural model fitness was also confirmed (CMIN=488.6; CMIN/DF=1.85; GFI=0.861; AGFI=0.893; NFI=0.987; CFI=0.945; RMR=0:079; RMSEA=0.053). Hence, the results indicated that social media usefulness has a positive and significant effect on health awareness (hypothesis 1: β=.669, P<.001), and health awareness has a positive and significant effect on health care education in Pakistan (hypothesis 2: β=.557, P<.001).</p><p><strong>Conclusions: </strong>This study concludes that health care professionals and paramedic staff in private hospitals support the use of social media to raise awareness and pr","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"12 ","pages":"e65745"},"PeriodicalIF":2.6,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"User Intent to Use DeepSeek for Healthcare Purposes and their Trust in the Large Language Model: Multinational Survey Study.","authors":"Avishek Choudhury, Yeganeh Shahsavar, Hamid Shamszare","doi":"10.2196/72867","DOIUrl":"https://doi.org/10.2196/72867","url":null,"abstract":"<p><strong>Background: </strong>Generative artificial intelligence (Gen-AI)-particularly large language models (LLMs)-has generated unprecedented interest in applications ranging from everyday Q&A to health-related inquiries. However, little is known about how everyday users decide whether to trust and adopt these technologies-particularly in high-stakes contexts like personal health.</p><p><strong>Objective: </strong>This study examines how ease of use, perceived usefulness, and risk perception interact to shape user trust in and intentions to adopt DeepSeek, an emerging LLM-based platform, for healthcare purposes.</p><p><strong>Methods: </strong>We adapted survey items from validated technology acceptance scales to assess user perception of DeepSeek, focusing on constructs such as trust, intent to use for health, ease of use, perceived usefulness, and risk perception. A 12-item Likert scale questionnaire was developed and pilot-tested (n=20) for clarity and consistency. It was then distributed online to users in India (IND), United Kingdom (UK), and United States of America (USA) who had used DeepSeek within the past two weeks. Data analysis involved descriptive frequency assessments and Partial Least Squares Structural Equation Modeling (PLS-SEM) to evaluate the measurement and structural models. Structural equation modeling assessed direct and indirect effects, including potential quadratic relationships.</p><p><strong>Results: </strong>A total of 556 complete responses were collected, with respondents almost evenly split across IND (n=184), the UK (n=185), and the USA (n=187). Regarding AI in healthcare, when asked if they were comfortable with their healthcare provider using AI tools, 59.3% (n=330) were fine with AI use provided their doctor verified its output, and 31.5% (n=175) were enthusiastic about its use without conditions. DeepSeek was used primarily for academic and educational purposes, 50.7% (n=282) used DeepSeek as a search engine, and 47.7% (n=265) for health-related queries. When asked about their intent to adopt DeepSeek over other LLMs like ChatGPT, 52.1% (n=290) were likely to switch, and 28.9% (n=161) were very likely to do so. The study revealed that trust plays a pivotal mediating role: ease of use exerts a significant indirect impact on usage intentions through trust. At the same time, perceived usefulness contributes to trust development and direct adoption. By contrast, risk perception negatively affects usage intent, emphasizing the importance of robust data governance and transparency. Significant non-linear paths were observed for ease of use and risk, indicating threshold or plateau effects.</p><p><strong>Conclusions: </strong>Users are receptive to DeepSeek when it's easy to use, useful, and trustworthy. The model highlights trust as a mediator and shows non-linear dynamics shaping AI-driven healthcare tool adoption. Expanding the model with mediators like privacy and cultural differences could provide deeper ins","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"User-Centered Design of an Electronic Dashboard for Monitoring Facility-Level Basic Emergency Obstetric Care Readiness in Amhara, Ethiopia: Mixed Methods Study.","authors":"Kylie Dougherty, Yihenew Tesfaye, Heran Biza, Mulusew Belew, Natalie Benda, Abebe Gebremariam Gobezayehu, John Cranmer, Suzanne Bakken","doi":"10.2196/64131","DOIUrl":"https://doi.org/10.2196/64131","url":null,"abstract":"<p><strong>Background: </strong>Maternal mortality remains a persistent public health concern in sub-Saharan African countries such as Ethiopia. Health information technology solutions are a flexible and low-cost method for improving health outcomes with proven benefits in low- to middle-income countries' health systems.</p><p><strong>Objective: </strong>This study aimed to develop and assess the usability of an electronic dashboard to monitor facility-level readiness to manage basic emergency obstetric care (BEmOC) in Amhara, Ethiopia.</p><p><strong>Methods: </strong>The study used three methods to iteratively refine the dashboard: (1) user-centered design sessions with individuals who interact with the BEmOC supply chain, (2) review and feedback from domain and information visualization subject matter experts (SMEs) to refine the dashboard, and (3) usability heuristic evaluation with human-computer interaction (HCI) SMEs.</p><p><strong>Results: </strong>User-centered design sessions resulted in a preliminary version of the dashboard informed by end-user preferences and perceptions, with recommendations focusing on aesthetic design, filtering and sorting, and matching with the real world. An example of an end-user recommendation included increasing font sizes on the dashboard and using a red, yellow, and green color-coding scheme. Next, domain and visualization SMEs continued the dashboard's iterative refinement, focusing on aesthetic design and navigation, by confirming design choices incorporated from the user-centered design sessions and recommending changes to enhance user experience moving through the dashboard, such as adding more filtering options. HCI SMEs rated the dashboard as highly usable (0.82 on a scale of 0-4, with 0 being no usability concern and 4 being a catastrophic usability concern). The principle with the highest usability severity scores was a match between the system and the real world with a score of 1.4. The HCI SMEs also rated the information visualization aspects of the dashboard favorably with 2 usability principles, spatial organization and information coding, scoring 0.</p><p><strong>Conclusions: </strong>Dashboards are a novel method for promoting and tracking facility capacity to manage BEmOC. By including targeted end users and SMEs in the design process, the team was able to tailor the dashboard to meet user needs, fit it into the existing government health systems, and ensure that the dashboard follows design best practices. Collectively, the novel, customized BEmOC dashboard can be used to track and improve facility-level readiness in Amhara, Ethiopia, and similar global BEmOC facilities.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"12 ","pages":"e64131"},"PeriodicalIF":2.6,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Bottom-Up Cocreation of Nursing Technological Innovations: Explorative Interview Study Among Hospital Nurses and Managers.","authors":"Saskia van Steenis, Onno Helder, Helianthe S M Kort, Thijs van Houwelingen","doi":"10.2196/60543","DOIUrl":"https://doi.org/10.2196/60543","url":null,"abstract":"<p><strong>Background: </strong>In health care, the use of nursing technological innovations, particularly technological products, is rapidly increasing; however, these innovations do not always align with nursing practice. An explanation for this issue could be that nursing technological innovations are developed and implemented with a top-down approach, which could subsequently limit the positive impact on practice. Cocreation with stakeholders such as nurses can help address this issue. Nowadays, health care centers increasingly encourage stakeholder participation, which is known as a bottom-up cocreation approach. However, little is known about the experience of nurses and their managers with this approach and the innovations it results in within the field of nursing care.</p><p><strong>Objective: </strong>This study aims to explore nurses' and their managers' experiences with a bottom-up cocreation approach in order to assess the impact of this way of working and the resulting nursing technological innovations in an academic hospital. This insight can also inform decisions on whether the bottom-up cocreation approach should be more widely disseminated.</p><p><strong>Methods: </strong>A qualitative study using semistructured interviews was conducted with 15 participants, including cocreator nurses, end-user nurses, and their managers. First, the data were thematically analyzed. In addition, a strengths, weaknesses, opportunities, and threats analysis was conducted.</p><p><strong>Results: </strong>The various experiences of the participants were described in 3 main themes: enhanced attractiveness of the nursing profession, feeling involved due to a cocreation environment, and experienced benefits and challenges in using cocreated products. In addition, numerous strengths and opportunities perceived by the participants were identified as associated with the bottom-up cocreation approach and resulting useful products within nursing care; for example, cocreation contributed to job satisfaction and substantially contributed to the ease of use of the innovations that were developed.</p><p><strong>Conclusions: </strong>The findings underscore that cocreation with nurses enhances the appeal of the nursing profession and aligns nursing technological innovations with practical nursing challenges. Embracing a culture of cocreation has the potential to foster a culture of continuous improvement and innovation in nursing care.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"12 ","pages":"e60543"},"PeriodicalIF":2.6,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perception and Evaluation of a Knowledge Transfer Concept in a Digital Health Application for Patients With Heart Failure: Mixed Methods Study.","authors":"Madeleine Flaucher, Sabrina Berzins, Katharina M Jaeger, Michael Nissen, Jana Rolny, Patricia Trißler, Sebastian Eckl, Bjoern M Eskofier, Heike Leutheuser","doi":"10.2196/56798","DOIUrl":"10.2196/56798","url":null,"abstract":"<p><strong>Background: </strong>Digital health education can enhance the quality of life of patients with heart failure by providing accessible and tailored information, which is essential for effective self-care and self-management.</p><p><strong>Objective: </strong>This work aims to develop a mobile health knowledge transfer concept for heart failure in a user-centered design process grounded in theoretical frameworks. This approach centers on enhancing the usability, patient engagement, and meaningfulness of mobile health education in the context of heart failure.</p><p><strong>Methods: </strong>A user-centered design process was employed. First, semistructured stakeholder interviews were conducted with patients (n=9) and medical experts (n=5). The results were used to develop a health knowledge transfer concept for a mobile health app for heart failure. This concept was implemented as a digital prototype based on an existing German mobile health app for patients with heart failure. We used this prototype to evaluate our concept with patients with heart failure in a study composed of user testing and semistructured patient interviews (n=7).</p><p><strong>Results: </strong>Stakeholder interviews identified five themes relevant to mobile health education: individualization, content relevance, media diversity, motivation strategies, and trust-building mechanisms. The evaluation of our prototype showed that patients value the adaptation of content to individual interests and prior knowledge. Digital rewards such as badges and push notifications can increase motivation and engagement but should be used with care to avoid overload, irrelevance, and repetition.</p><p><strong>Conclusions: </strong>Our findings emphasize the importance of tailoring mobile health education to the specific needs and preferences of patients with heart failure. At the same time, they also highlight the careful implementation of motivation strategies to promote user engagement effectively. These implications offer guidance for developing more impactful interventions to improve health outcomes for this population.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"12 ","pages":"e56798"},"PeriodicalIF":2.6,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11975119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Informatics-Based, Payer-Led, Low-Intensity Multichannel Educational Campaign Decreases Post-Discharge Utilization in Medicare Advantage Members.","authors":"Danica Fernandes, Elise Kokonas, Jai Bansal, Ken Hayashima, Brian Hurley, Annabel Ryu, Snehal Mhatre, Mohammed Ghori, Kelly Jean Craig, Amanda L Zaleski, Lily Vogel, Szu-Min Yu, Alena Baquet-Simpson, Daniel Reif","doi":"10.2196/63841","DOIUrl":"https://doi.org/10.2196/63841","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Readmission avoidance initiatives have been a priority for the Centers for Medicare & Medicaid Services for over a decade; however, interventions are often high-intensity, costly, and resource-intensive, and therefore, rarely scalable or sustainable. Large national payors are in a unique position to leverage data to identify members in real-time who are at high-risk of readmission to prioritize the scaled delivery of tailored behavior change techniques to provide an educational intervention to modify health behaviors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To examine the impact of an informatics-driven, multichannel educational messaging campaign implemented to decrease 30- and 90-day acute inpatient readmissions and emergency department (ED) visits among Medicare Advantage members of a large national payor.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A quality improvement initiative was designed and implemented to provide an evidence-based outreach campaign using human-centered design and behavior change principles to deliver multiple intervention functions, including timely, contextual, and relevant delivery of education, enablement, and persuasion, to reinforce health promoting behaviors related to planned or unplanned inpatient admissions. Outcomes including 30- and 90-day acute inpatient readmissions and ED visits were retrospectively evaluated from Medicare Advantage members enrolled in a large national health plan residing across the United States between May 2020 and July 2022. Leveraging utilization management data, rules-based logic identified members (N=368,393) with a planned acute inpatient procedure (i.e., pre-admission) or discharged from an acute hospital stay (i.e., post-discharge) within 15 days. Members were sequentially assigned to a standard (N=141,223) or an enhanced (N=227,470) messaging group, whereby the standard group received usual outreach and the enhanced group received an educational intervention via a messaging campaign deployed through multiple low-intensity communication channels (e.g., text message, email, direct mail) in addition to standard outreach.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Members who received enhanced outreach had fewer relative 30-day acute inpatient readmissions (-4.1%, 95% CI: -5.5 to -2.7 %; P&lt;.001) and ED visits (-3.4%, 95% CI: -5.0 to -1.7%; P&lt;.001) compared to members receiving standard outreach. Similarly, these findings persisted for relative 90-day outcomes such that members receiving enhanced outreach experienced fewer acute inpatient readmissions (-5.4%, 95% CI: -6.5 to -4.3%; P&lt;.001) and ED visits (-3.8%, 95% CI: -5.0 to -2.5%; P&lt;.001) compared to members receiving standard outreach messaging.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Behavior change techniques deployed via educational interventions as low-intensity multi-channel outreach is an effective strategy to reduce avoidable 30- and 90-day inpatient readmissions and ED visits in recently discharged Medicare Advantage memb","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Usability, Acceptability, User Experience, and Design of an Interactive Responsive Platform to Improve Perinatal Nurses' Stigmatizing Attitudes Toward Substance Use In Pregnancy.","authors":"Michael Rubyan, Yana Gouseinov, Mikayla Morgan, Deborah Rubyan, Divya Jahagirdar, David Choberka, Carol Boyd, Clayton Shuman","doi":"10.2196/67685","DOIUrl":"https://doi.org/10.2196/67685","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Perinatal nurses are increasingly encountering patients who have engaged in perinatal substance use (PSU). Despite growing evidence demonstrating the need to reduce nurses' stigmatizing attitudes toward PSU, limited interventions are available to target these attitudes and support behavior change - especially those that reflect the overwhelming evidence that education alone is insufficient to change practice behavior. Arts-based interventions are associated with increasing nursing empathy, changing patient attitudes, improving reflective practice, and decreasing stigma. We adapted ArtSpective™ for PSU, a previously evaluated arts-based intervention to reduce stigma among perinatal nurses, into an interactive digital responsive platform that facilitates intervention delivery asynchronously.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to evaluate the usability, acceptability, and feasibility of the interactive, responsive platform version of ArtSpective™ for PSU, designed to deliver an adapted version of the in-person intervention to improve nurses' stigmatizing attitudes toward PSU, following a mixed methods approach. Our goal was to elicit user experience strengths and weaknesses related to the design of the responsive platform and identify strategies to overcome them.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study used a mixed-methods approach to explore the platform's usability and user experience and its acceptability as an intervention to address stigma and implicit bias related to PSU. Theatre testing was used to qualitatively assess usability and acceptability perspectives with nurses and experts, as well as a modified version of the previously validated 8-item Abbreviated Acceptability Rating Profile for quantitative assessment. Analyses of quantitative data regarding acceptability and satisfaction were performed using descriptive statistics (mean, standard deviation, frequency, percentage). All qualitative data were analyzed iteratively using an inductive framework analysis approach.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 21 nurses and four experts in stigma, implicit bias, and instructional design completed theatre-testing sessions. The mean duration of interviews for nurses was 31.92 (SD 11.32) minutes, and for experts, 40.73 (SD 8.57) minutes. All participants indicated that they found the digital adaptation of the intervention to be highly acceptable, with mean acceptability items ranging from 5.0 (SD 1.0) to 5.5 (SD 0.6) on a 1-6 agreement scale. Nurses reported high satisfaction with the platform on a 1-6 agreement scale, with mean satisfaction items ranging from 5.14 (SD 0.56) to 5.29 (SD 0.63) on a 1-6 agreement scale. 1,797 interview segments were coded from the theatre-testing sessions with four major themes: appearance, navigation, characterization, and overall platform, and 16 subthemes were identified. Consistent with the quantitative findings, the results were positive overall, with par","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Best Practice Guide for Reducing Barriers to Video Call-Based Telehealth: Modified Delphi Study Among Health Care Professionals.","authors":"Lena Rettinger, Lea Aichinger, Veronika Ertelt-Bach, Andreas Huber, Susanne Maria Javorszky, Lukas Maul, Peter Putz, Sevan Sargis, Franz Werner, Klaus Widhalm, Sebastian Kuhn","doi":"10.2196/64079","DOIUrl":"https://doi.org/10.2196/64079","url":null,"abstract":"<p><strong>Background: </strong>Telehealth has grown, especially during the COVID-19 pandemic, improving access for those in remote or underserved areas. However, its implementation faces technological, practical, and interpersonal barriers.</p><p><strong>Objective: </strong>The aim of this study was to identify and consolidate best practices for telehealth delivery, specifically for video call sessions, by synthesizing the insights of health care professionals across various disciplines.</p><p><strong>Methods: </strong>We first identified 15 common telehealth barriers from a preceding scoping review. Subsequently, a modified Delphi method was used, involving 9 health care professionals (physiotherapists, speech and language therapists, dietitians, and midwife) with telehealth experience in qualitative interviews and 2 iterative rounds of web-based surveys to form consensus.</p><p><strong>Results: </strong>This study addressed 15 telehealth barriers and identified 105 best practices. Among these, 20 are technology-related and 85 concern health care practices. Emphasis was placed on setting up telehealth environments, ensuring safety, building relationships and trust, using nonmanual methods, and enhancing observation and assessment skills. Best practice recommendations for dealing with patients or caregiver skepticism or lack of telehealth-specific knowledge were developed. Further, approaches for unstable networks and privacy and IT security issues were identified. Areas with fewer best practices were the lack of technology skills or technology access, unreliability of hardware and software, increased workload, and a lack of caregiver support.</p><p><strong>Conclusions: </strong>This guide of best practices serves as an actionable resource for health care providers to navigate the complexities of telehealth. Despite a small participant sample and the potential for profession-specific biases, the findings provide a foundation for improving telehealth services and inform future research for its application and education.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"12 ","pages":"e64079"},"PeriodicalIF":2.6,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}