JMIR Human Factors最新文献

{"title":"Persuasive Systems Design Features of Smartphone Apps for Psychosis: Systematic Review.","authors":"Theresa Taylor, Jasmin Peat, David Kell, Shadi Daryan, Pamela Jacobsen","doi":"10.2196/81101","DOIUrl":"10.2196/81101","url":null,"abstract":"<p><strong>Background: </strong>It is unclear why some smartphone apps designed for people with psychosis are engaging, while others are not. One possible explanation is the apps' persuasive features and the operationalization and implementation of these features.</p><p><strong>Objective: </strong>This systematic review set out to quantify and describe the persuasive features used in smartphone apps for psychosis, investigate whether there was any association between persuasive features and attrition or adherence rates. and document the quality of the included apps.</p><p><strong>Methods: </strong>We searched electronic databases PsycINFO, PubMed, and Google Scholar for eligible papers published between the years of 2013 and 2025. Hand searches of reference lists were completed. Apps were selected if they were designed for people with psychosis and there were published empirical studies investigating the apps. Two reviewers from the review team (TT, JP, DK, and SD) independently screened papers and extracted data on adherence and attrition, as well as coded papers for evidence of persuasive features according to the persuasive systems design (PSD) model. Available data were synthesized descriptively and narratively. We attempted to access apps via app stores or by correspondence with the research team.</p><p><strong>Results: </strong>We found 22 apps for psychosis, with 30 associated published papers. The persuasive features were as follows: personalization (18 apps); reminders (15 apps); suggestions (11 apps); tunneling and self-monitoring (10 apps); reduction (9 apps); liking (8 apps); social role (6 apps); rehearsal, praise, and similarity (5 apps); rewards (4 apps); simulation, real-world feel, and social learning (3 apps); surface credibility and normative influence (2 apps); and trustworthiness, social comparison, and social facilitation (1 app). Expertise, authority, third-party endorsements, verifiability, cooperation, competition, and recognition were present in zero apps. Features in the categories of primary task support and dialogue support were well represented, while social support and system credibility support were underused. It was found that there was no association between the number of persuasive features and attrition; an association between persuasive features and adherence could not be assessed. The quality of the apps could not be judged due to 20 of the 22 apps being inaccessible either through the research papers' authors or through app stores.</p><p><strong>Conclusions: </strong>Our findings indicate that in psychosis apps there is potential to include a broader range of persuasive features, which might maximize engagement. Psychosis apps may benefit from incorporating more features that leverage the persuasive impact of having users interact (social support) and incorporating features that emphasize system credibility and trustworthiness. Further studies could determine whether an increase in the number of persuasive f","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e81101"},"PeriodicalIF":3.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13151958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843800","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":"Examining the Effect of Online Engagement on Older Adults' Subjective Memory Capability: Cross-Sectional Path Analysis.","authors":"Soohyoung Rain Lee, Hang Liu","doi":"10.2196/73018","DOIUrl":"10.2196/73018","url":null,"abstract":"<p><strong>Background: </strong>The utility of online engagement in enhancing quality of life and mitigating social isolation among older adults is well documented. However, its relationship with cognitive functioning, particularly through online engagement, requires further exploration.</p><p><strong>Objective: </strong>This study investigated whether active online engagement via the Virtual Senior Center (VSC) program was associated with subjective memory capability among older adults and whether subjective memory capability was associated with psychological well-being and loneliness.</p><p><strong>Methods: </strong>This study included a cross-sectional sample of 53 homebound older adults participating in the VSC program, which offers diverse online classes to promote social interaction. Path analysis was conducted to examine the associations among online engagement, subjective memory capability, quality of life, and loneliness.</p><p><strong>Results: </strong>Increased participation in VSC activities was associated with higher subjective memory capability (β=0.29, 95% CI 0.04-0.54; P<.02). Subjective memory capability was associated with better quality of life (β=0.29, 95% CI 0.04-0.54; P<.001) and lower loneliness (β=0.29, 95% CI 0.04-0.54; P<.003). No direct associations were observed between online engagement and quality of life or loneliness.</p><p><strong>Conclusions: </strong>Subjective memory capability was associated with better quality of life and lower loneliness. Although online engagement had no direct association with quality of life and loneliness, the observed indirect pattern suggests that subjective memory capability may represent a psychologically meaningful pathway through which structured online engagement relates to well-being. These findings highlight the potential of digital platforms to complement traditional forms of socialization, particularly for older adults facing physical or geographic barriers to interaction.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e73018"},"PeriodicalIF":3.0,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13148760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843779","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":"Digital Episodic Future Thinking Intervention (Luminaut): Co-Design and Iterative Development Study.","authors":"Naomi Hoffmann, Caitlin A Howlett, Kate Little, Ian Gwilt, Megan A Rebuli, Paige G Brooker, Aaron Davis","doi":"10.2196/74099","DOIUrl":"10.2196/74099","url":null,"abstract":"<p><strong>Background: </strong>Digital health interventions can be effective at changing behavior, but achieving long-term adherence remains a challenge. One psychological barrier to health behavior change is future discounting, or the tendency to prefer smaller, short-term rewards over larger, long-term rewards. Episodic Future Thinking (EFT) can disrupt future discounting and is a promising technique for improving health behavior, but such interventions have not been co-designed to address end user needs.</p><p><strong>Objective: </strong>This study aimed to co-design an app with end users to deliver an EFT intervention aimed at promoting health behavior change in those in the prerisk phase for chronic conditions.</p><p><strong>Methods: </strong>Community members participated in up to 2 series of face-to-face co-design workshops. A prototype of the app was reviewed, and insights were gathered to understand (1) the optimal characteristics of the app and (2) the concepts of future discounting and EFT. Themes were generated using inductive thematic analysis.</p><p><strong>Results: </strong>Participants were South Australian adults (n=30) who were predominately affluent women (27/30, 90%) aged 25-44 years (mean 36.37, SD 5.65 years). Feedback generated from the first workshop series resulted in 26 suggestions of which 15 informed iterative app development. Higher-level principles were identified and categorized into 5 overarching themes: concept acceptance, triggers and barriers, personalization, gamification, and user-friendly interface.</p><p><strong>Conclusions: </strong>This study used co-design methodology to develop an app-based EFT intervention. Ongoing engagement with end users and key stakeholders (eg, health care professionals) is needed to ensure that the app meets changing needs. Future work will aim to evaluate its effectiveness in a large-scale clinical trial.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e74099"},"PeriodicalIF":3.0,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13148339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843805","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":"Service Users' Views on Digital Remote Monitoring for Psychosis: Survey Study.","authors":"Xiaolong Zhang, Emily Eisner, Daniela Di Basilio, Cara Richardson, Joseph Firth, Sandra Bucci","doi":"10.2196/86152","DOIUrl":"https://doi.org/10.2196/86152","url":null,"abstract":"<p><strong>Background: </strong>Digital remote monitoring using smartphones and wearable devices is a promising solution for psychosis management, where precise, time-sensitive intervention is crucial. Combining active symptom monitoring (ASM) and passive sensing (PS) can support self-management by allowing remote, low-burden mental health monitoring.</p><p><strong>Objective: </strong>This study aimed to explore (1) views on collecting data using ASM and PS methods and comfort levels with different types of data gathered via these methods, (2) views on using smartphones and wearable devices in the context of mental health care, and (3) the ownership and usage of smartphones and wearable devices.</p><p><strong>Methods: </strong>We conducted a cross-sectional survey study with service users with psychosis in the United Kingdom between March 2023 and March 2024.</p><p><strong>Results: </strong>A total of 309 participants completed the survey. They reported mixed views on using ASM and PS technologies for monitoring mental health, with more participants endorsing the concept than opposing it (ASM: n=145, 46.9% and PS: n=132, 42.7%). However, the type of data gathered using these methods was an important factor. Collecting personal information was deemed less acceptable (P<.001) than other data types (physical health, mental health, environment, and nonpersonal device information).</p><p><strong>Conclusions: </strong>We found that participants were comfortable with using apps and wearables for digital remote monitoring, though personal information was less acceptable than other data types due to privacy and surveillance concerns. This highlights the importance of further exploring trust issues related to digital monitoring and ensuring that end users have choices regarding the types of data that digital systems gather and share with mental health services.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e86152"},"PeriodicalIF":3.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843817","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":"Feasibility and Acceptability of a Prevention-Focused Screener for Perinatal Depression Risk: Mixed Methods Cohort Study.","authors":"Tamar Krishnamurti, Samantha Rodriguez, Leah Cope, Lara Lemon, Priya Gopalan, Cara Nikolajski, Hyagriv Simhan, Kelly Williams","doi":"10.2196/81638","DOIUrl":"10.2196/81638","url":null,"abstract":"<p><strong>Background: </strong>More than 20% of perinatal women experience depression, with suicide being a leading cause of maternal death in the United States. Professional societies emphasize the need to identify those at risk of developing perinatal depression to better target preventive care delivery during pregnancy.</p><p><strong>Objective: </strong>We evaluated receptivity to a machine learning-based predictive screener designed to identify women in the first trimester of pregnancy who were asymptomatic but were at risk for developing moderate to severe depression symptoms later in pregnancy.</p><p><strong>Methods: </strong>Our participants were adult pregnant women with negative first-trimester depression (Patient Health Questionnaire-9) screens at 1 of 4 obstetric practices. Of the 810 women who were clinically eligible, 787 were successfully contacted via their patient portal. Of these, 289 (36.7%) viewed the screener and 255 (88.2%) completed the 6-question predictive screener. In total, 51 (20%) were identified by the screener as being at risk for developing perinatal depression. Participants were asked a series of follow-up questions regarding the acceptability of the predictive screener and desired preventive resources. Chi-square tests were used to compare demographic characteristics, perceived benefits and concerns, and desired resources between those identified as at risk for depression and those who were not. Differences in acceptability ratings between the two risk groups were determined using nonparametric Mann-Whitney U tests.</p><p><strong>Results: </strong>On a 5-point Likert scale of agreement, participants found the screener questions easy to complete (median score 5, IQR 5-5) and felt comfortable sharing their answers with their obstetric care providers (median 5, IQR 4-5). Key perceived benefits of completing the screener included opportunities to seek preventive care (75/255, 29.4%) and to receive education on depression risk (66/255, 25.9%). Primary concerns about knowing one's risk of future depression included worrying about developing depression (90/255, 35.3%) and a lack of prevention opportunities (39/255, 15.3%). Desired preventive resources included counseling (197/255, 77.3%), mind-body interventions (166/255, 65.1%) such as exercise, and prenatal classes or support groups (81/255, 31.8%).</p><p><strong>Conclusions: </strong>Participants found the screener acceptable and felt comfortable receiving it through their patient portal. Specific preventive care options were commonly endorsed, several of which are scalable and evidence based. A minority of participants voiced addressable concerns about knowing their risk of developing depression in the future.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e81638"},"PeriodicalIF":3.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843782","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":"Identifying Skill and Usability Barriers to Digital Health Tool Use Among Older Adult Patients in US Safety Net Clinics: Mixed Methods Study.","authors":"Taylor Rapson, Magaly Ramirez, Sandy He, Jeanette Wong, Hyunjin Cindy Kim, Isabel Luna, Andersen Yang, Junhong Li, Paul A Fishman, James D Ralston, Courtney R Lyles, Elaine C Khoong","doi":"10.2196/78430","DOIUrl":"https://doi.org/10.2196/78430","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Despite their benefits, digital health tools often face adoption barriers because of the digital divide. Identifying the fundamental user skills required to effectively navigate these tools and the usability barriers is essential to addressing disparities in use.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to identify the skill and usability barriers to using digital health tools.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study included English-, Spanish-, or Cantonese-speaking patients, aged ≥50 years, who received care at an urban safety net health system in the United States. Participants completed a survey examining sociodemographic characteristics and digital health tool use and were observed and video recorded as they navigated four digital health care tasks: (1) launch a video visit, (2) visit a health website through a URL, (3) log in to the patient portal, and (4) sign up for a patient portal account. Participants who could not independently perform the tasks received additional support. Tasks were conducted in English, while instructions and additional assistance were provided in each participant's preferred language. Video recordings were thematically coded to identify the fundamental skills needed for effective digital tool use and usability barriers in the design of digital tools. We examined whether task independence was associated with participant demographics and thematic categories using Kruskal-Wallis, χ2, and Fisher exact tests.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In total, 74% (34/46), 52% (31/60), 71% (44/62), and 70% (43/61) of participants (N=64) independently completed digital tasks 1, 2, 3, and 4, respectively. Older age, minoritized races and ethnicities, non-English language preference, lower educational attainment, access to cellular data only or no internet access, and lack of a portal account were associated with a higher likelihood of requiring assistance or being unsuccessful at completing each task (P&lt;.001, except for older age [P=.004]). The qualitative coding of video recordings identified 3, 4, and 6 categories of typing, navigation, and human-computer interaction (HCI) skills, respectively, as fundamental skills required to independently complete digital tasks. χ2 and Fisher exact tests indicated significant associations between most typing, navigation, and HCI categories and independent task completion. We coded usability barriers as one of 6 learnability challenges or 3 operability challenges.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study identified that independent use of digital health tools requires fundamental typing, navigation, or HCI skills as well as high usability of digital tools. The inclusion of 4 different digital tasks added specificity to the type of skills and usability considerations necessary to ensure accessibility of digital health tools to diverse older adults. This study underscores the need for vendors to cocreate digital health tools with historically ex","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e78430"},"PeriodicalIF":3.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843768","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":"High Screen Exposure and Its Association With Physical and Mental Well-Being Among School-Going Children and Adolescents in Bangladesh: Cross-Sectional Study.","authors":"Shahria Hafiz Kakon, Tanjir Rashid Soron, Mohammad Sharif Hossain, Biplob Hossain, Fahmida Tofail, Rashidul Haque","doi":"10.2196/73524","DOIUrl":"https://doi.org/10.2196/73524","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;In Bangladesh, as well as throughout the world, children's screen time has significantly increased. Children spend a lot of time on the internet and digital screens for entertainment, education, and communication, which has increased their daily screen time. However, the potential detrimental impacts of excessive screen time on children's mental, physical, and social health have drawn attention.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to explore the effect of high exposure to screens on the health and mental well-being of school-going children and adolescents in Dhaka, Bangladesh.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This cross-sectional descriptive study was conducted from July 2022 to June 2024. A total of 420 school-going children and adolescents aged 6 to 14 years were enrolled from 3 English-language and 3 Bangla-language schools in Dhaka using a stratified random sampling technique. Anthropometric measurements, a semistructured questionnaire, and the Pittsburgh Sleep Quality Index, the Development and Well-Being Assessment scale, and the Strengths and Difficulties Questionnaire, all of which were validated in Bangla, were used to gather data. We considered students who were exposed to screens for less than 2 hours a day as the low-exposure group and those who were exposed for more than 2 hours a day as the high-exposure group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 83.3% (350/420) of the students were in the high-exposure group, and their average screen time per day was 4.6 (SD 2.3) hours. Eye problems were reported by 35.7% (150/420) of the students, and a significant difference was found between the low- and high-exposure groups. In total, 96% (144/150) of the students with eye problems were from the high-exposure group, whereas 4% (6/150) were from the low-exposure group. Headaches were reported by 80% (336/420) of the students, and they were common in the high-exposure group (279/336, 83%). Moreover, students from the high-exposure group had a short duration and poor quality of sleep (mean 7.3, SD 1.4 hours), which was statistically significant. Furthermore, obesity was more predominant in the high-exposure group (P&lt;.001). Our study revealed that, overall, 31% (130/420) of the students had at least one mental health problem and 9.8% (41/420) had more than one mental health problem using the Development and Well-Being Assessment scale, and mental health problems were greater in the high-exposure group than the low-exposure group. Although behavioral problems such as conduct issues (119/420, 28.3%) and peer difficulties (121/420, 28.8%) were observed among the participants, no statistically significant difference was found between the 2 groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;A collaborative and coordinated multistage approach is essential to create effective and acceptable guidelines and policies for the optimum and positive use of digital screens for the children of Bangladesh. Further prosp","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e73524"},"PeriodicalIF":3.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843757","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":"The Role of Explanations in AI-Generated Alerts: Qualitative Study of Clinical Views on Explainable AI in Predictive Tools.","authors":"Jessica Rahman, Alana Delaforce, DanaKai Bradford, Jane Li, Farah Magrabi, David Cook, Aida Brankovic","doi":"10.2196/81460","DOIUrl":"https://doi.org/10.2196/81460","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI)-driven clinical decision support (CDS) tools offer promising solutions for health care delivery by optimizing resource allocation, detecting deterioration, and enabling early interventions. However, adoption remains limited due to insufficient validation and a lack of transparency and trust. Explainable AI (XAI) seeks to improve user understanding of AI outputs; however, how clinicians interpret and integrate these explanations into their decision-making remains underexplored. Furthermore, discrepancies in explanations, known as the \"disagreement problem,\" can undermine trust and, at worst, lead to poor clinical decisions.</p><p><strong>Objective: </strong>This study examines clinicians' perspectives on the role and value of explainability in AI-driven CDS tools within Australian critical care settings and the impact of discrepancies in AI-generated explanations on clinical decision-making.</p><p><strong>Methods: </strong>Qualitative data were collected using semistructured interviews with 14 clinical experts, incorporating scenario-based exercises, and were analyzed using inductive thematic analysis.</p><p><strong>Results: </strong>Clinicians valued explainability, particularly in complex or unfamiliar situations, when explanations were clear, plausible, and actionable. Trust and perceived usefulness extended beyond explanation quality, encompassing factors such as system accuracy, alignment with clinicians' reasoning, workflow integration, and perceived reliability. Discrepancies in explanations generated by different XAI methods were not a major concern, provided that the AI-generated predictive alerts were accurate.</p><p><strong>Conclusions: </strong>This study provides design recommendations for developing trustworthy, user-centric CDS tools that incorporate XAI. Findings highlight that explainability is critical for establishing initial trust in AI-driven tools by supporting perceived usefulness, but its importance diminishes over time and with user expertise and familiarity, as learned usefulness takes precedence. Recommendations highlight the importance of aligning the design and implementation of AI tools with clinicians' needs to enhance trust, mitigate risks, and promote successful adoption for improved patient outcomes.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e81460"},"PeriodicalIF":3.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13134825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821684","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":"User-Centered Design for Digital Patient-Navigation Tools in Oncology: Scoping Review.","authors":"Saba Kheirinejad, Brianna M White, Parnian Kheirkhah Rahimabad, Janet A Zink, Soheil Hashtarkhani, Fekede Asefa Kumsa, Rezaur Rashid, Lokesh Chinthala, Christopher L Brett, Robert L Davis, David L Schwartz, Arash Shaban-Nejad","doi":"10.2196/87686","DOIUrl":"https://doi.org/10.2196/87686","url":null,"abstract":"<p><strong>Background: </strong>Navigation programs for patients with cancer improve access and continuity of care, yet their digital transformation is often limited by poor usability and inadequate uptake. Applying user-centered and human-centered design (UCD/HCD) principles may close this gap, but the extent to which such design methods are used and evaluated in oncology navigation tools remains unclear.</p><p><strong>Objective: </strong>This scoping review identifies how UCD/HCD principles have been, and should be, applied in developing and implementing digital health tools for navigation for patients with cancer.</p><p><strong>Methods: </strong>A scoping review was conducted following PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) and Joanna Briggs Institute guidance. A total of 7 databases (PubMed/MEDLINE, Scopus, IEEE Xplore, Web of Science, Embase, ACM Digital Library, and CINAHL) were searched for English-language articles published between January 2015 and July 2025. Eligible studies reported original, peer-reviewed research on digital or mobile health interventions linked to cancer navigation and documented at least 1 UCD/HCD activity. Two reviewers independently screened records and charted data on context, target users, functions, tool modality, design phase, methods, and outcomes. Findings were synthesized descriptively and thematically.</p><p><strong>Results: </strong>A total of 36 studies met the inclusion criteria. Findings were organized into 4 domains: study characteristics, navigation functions and digital modalities, design processes and methods, and UCD/HCD application. Iterative prototyping and usability testing were the most common, while participatory design and implementation evaluation were underused.</p><p><strong>Conclusions: </strong>UCD/HCD approaches enhance usability and patient relevance of digital cancer navigation tools. However, their application remains limited across cancer types, regions, and functions. Broader stakeholder participation and evaluation beyond usability are needed to strengthen coordination, equity, and sustainability in cancer care.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e87686"},"PeriodicalIF":3.0,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783694","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":"Learning From the Adoption of a Readmission Clinical Decision Support Tool: Group Model Building Approach.","authors":"Nina Rachel Sperber, Sarah Elizabeth Haas, Jiaxin Gao, Samantha Hamelsky, Theresa Kiki-Teboum, Afraaz Malick, Rishab Pulugurta, Jacqueline Rodriguez, Hana Shafique, Eden Singh, Kriti Vasudevan, Scott Rockart, David Gallagher, Adam Johnson","doi":"10.2196/87522","DOIUrl":"10.2196/87522","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Computerized clinical decision support (CDS) has the potential to improve patient outcomes by offering evidence-based guidance at the point of care-enhancing guideline adherence and diagnostic accuracy-and supporting system-level outcomes by enabling predictive analytics for more efficient resource planning. Prior work has identified factors that affect adoption, such as clinicians' expectations of usefulness, ease of use, alignment with workflows, and resources to support utilization. However, CDS adoption is not static and changes according to dynamic systems of behaviors and workflows, requiring a deeper understanding of how evolving conditions affect implementation and outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To explore the dynamic factors influencing CDS adoption, we examined the implementation of the \"Unplanned readmission model version 1,\" developed by Epic Medical Records System, at Duke University Health System, using group model building and system dynamics modeling.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We first conducted group model-building workshops with staff (case managers, physical and occupational therapists, hospitalist faculty physicians, and resident physicians) who participate in decisions about discharging patients. Study team members guided participants to identify and connect variables in causal loop diagrams. We coded workshop transcripts in software designed for system dynamics analysis to identify themes, aggregated them into a causal loop diagram, and reviewed them with participants to converge on a common model. A team member applied equations to the pathways and tested data to simulate conditions leading to full, limited, or no adoption of a tool.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We identified key balancing loops driven by external pressure (eg, Centers for Medicare & Medicaid Services penalties) that motivated initial adoption and reinforcing loops based on perceived internal benefits to sustain use. While institutional incentives led to early training and tool use, efforts declined due to staff turnover, competing priorities (eg, COVID-19), and workflow changes. Reinforcing loops emerged when staff described clinical utility, such as improved discharge planning and team communication. However, staff also suggested that these loops were often weak due to difficulty linking the use of the tool to outcomes in real time. Simulation modeling showed that while strong external pressure and rapid training led to initial success, interest in using the tool waned as workflows improved and readmission rates approached Centers for Medicare & Medicaid Services goals. When conflicting priorities were introduced, adoption stalled earlier, and fewer staff were trained. In contrast, when internal motivation was strengthened by reducing the amount of evidence needed to perceive success, individual interest remained high even as institutional attention declined, sustaining tool use and further reducing re","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e87522"},"PeriodicalIF":3.0,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13128158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783364","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}