JMIR Human Factors最新文献

{"title":"From Prototype to Practice: Mixed Methods Study of Human-Centered Design and Usability Evaluation of Augmented Reality for Complex Oncology Surgical Workflows.","authors":"Maria Matsangidou, Mikolaj R Kowal, Jakob Yianni, Maria Krini, Samir Pathak, Katie Gordon, Malcolm A Luker, Deborah D Stocken, David Jayne, Constantinos S Pattichis","doi":"10.2196/86725","DOIUrl":"https://doi.org/10.2196/86725","url":null,"abstract":"<p><strong>Background: </strong>Hepato-pancreato-biliary (HPB) oncology involves complex surgical planning and multidisciplinary decision-making that present significant cognitive, spatial, and communicative challenges. While augmented reality (AR) technologies are emerging as valuable tools in surgical planning, most existing systems are developed in a technologically deterministic manner, often without consideration of patients' lived experiences or the collaborative needs of multidisciplinary clinical teams. This limits their integration into complex workflows and their potential for meaningful clinical impact.</p><p><strong>Objective: </strong>This study aimed to co-design and evaluate a human-centered AR system that supports spatial understanding, emotional sensitivity, and collaborative decision-making in HPB surgical oncology.</p><p><strong>Methods: </strong>This mixed methods human-centered design study was conducted between February 2024 and September 2025 and comprised 2 phases. In Phase 1, convenience sampling was used to recruit 14 oncology health care professionals (surgeons, oncologists, and psycho-oncology specialists) and 10 patients with cancer from multidisciplinary oncology care settings to participate in co-design workshops and semistructured interviews exploring the cognitive, communicative, emotional, and workflow requirements for an AR system supporting HPB surgical oncology. Qualitative data were analyzed using reflexive thematic analysis and informed iterative prototype development. In Phase 2, the resulting AR prototype was evaluated through usability testing with 10 hepatobiliary clinicians using simulated multidisciplinary tumor board planning scenarios. Usability was assessed using the System Usability Scale (SUS), supplemented by observational data and qualitative feedback.</p><p><strong>Results: </strong>The co-design process identified intersecting spatial, cognitive, emotional, and communicative challenges in HPB surgical oncology. These findings informed the iterative development of an AR prototype that functioned as a shared cognitive and communicative workspace. The system enabled collaborative manipulation of 3D anatomical models, emotionally calibrated visualizations, and seamless integration with existing planning workflows. The prototype achieved a mean SUS score of 67.25 (SD 7.95), indicating acceptable usability. In simulated multidisciplinary tumor board scenarios, clinicians reported improved spatial understanding, reduced cognitive load, and enhanced interdisciplinary communication. Patients with cancer participating in the co-design phase valued the ability to engage with their own anatomy in an emotionally manageable way and reported that interactive visualization improved their understanding and sense of agency. Overall, the findings suggest that AR systems designed with human-centered methods can function not only as visualization tools but also as boundary objects that support communication and di","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e86725"},"PeriodicalIF":3.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149115752","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":"Exploratory Analysis of the Digital Health Gender Paradox in Consumer-Facing Digital Health Technology Adoption: Cross-Sectional Survey Study.","authors":"Jessica Kathleen Wallace, Mehak Batra, Tafheem Ahmad Wani, Michael Liem, Kylie Ovenden, James Boyd, Therese Keane, Urooj Raza Khan","doi":"10.2196/101963","DOIUrl":"10.2196/101963","url":null,"abstract":"<p><strong>Background: </strong>Digital health technologies have become integral to modern health care, yet consumer adoption remains uneven. These technologies span a range of consumer-facing tools, including remote care services, mobile apps, wearable devices, conversational agents, and digital medication services, with uptake varying considerably across tool types and by gender. An earlier analysis of this dataset revealed a gender paradox: women reported higher digital literacy compared to men yet demonstrated lower adoption and curiosity toward digital health tools. The Capability, Opportunity, Motivation - Behavior (COM-B) model proposes that behavior occurs when individuals have the capability (skills and confidence), opportunity (access, affordability, and contextual support), and motivation (trust, perceived usefulness, and willingness) to act.</p><p><strong>Objective: </strong>This study aimed to examine associations between digital literacy, self-reported COM-B domains, gender, and adoption across digital health technologies and to explore whether these associations differ by gender.</p><p><strong>Methods: </strong>This cross-sectional quantitative study with an integrated qualitative component enrolled 416 adults and used multivariable logistic regression to examine associations between COM-B domains and adoption across five consumer-facing digital health technologies. Exploratory gender-by-predictor interaction and gender-stratified analyses examined potential gender-specific patterns, while self-reported reasons for nonuse were mapped to COM-B domains using directed content analysis.</p><p><strong>Results: </strong>Women had lower odds of chatbot/virtual assistant use (adjusted odds ratio [aOR] 0.32, 95% CI 0.18-0.59), marginally lower odds of e-pharmacy use (aOR 0.48, 95% CI 0.22-1.01), and higher odds of mobile health (mHealth) app use (aOR 2.59, 95% CI 1.28-5.25). Of 20 exploratory interaction tests, chatbot digital literacy-by-gender (P=.021) and capability-by-gender (P=.044) interactions were nominally significant. In directed barrier analysis, the gender distribution differed significantly for mHealth apps (P=.009), whereas the wearable result showed a trend (P=.079); motivation-related barriers were most frequent for most technologies.</p><p><strong>Conclusions: </strong>Behavioral determinants of digital health technology adoption varied by technology type. Women used several technologies less often than men despite reporting higher digital literacy, capability, and motivation, and opportunity emerged as the most consistent factor across the models examined. Exploratory analyses suggested these patterns may differ by gender for selected technologies but did not support a single gender-differentiated pathway. These findings are exploratory and require confirmation in larger studies.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e101963"},"PeriodicalIF":3.9,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082202","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":"Health Care Workers' Perspectives on Virtual Reality in Mental Health: Qualitative Interview Study.","authors":"Anna Szczegielniak, Jakub Możaryn, Łukasz Kunert, Szymon Florek, Robert Pudlo","doi":"10.2196/80851","DOIUrl":"10.2196/80851","url":null,"abstract":"<p><strong>Background: </strong>Virtual reality (VR) offers immersive, interactive environments, with growing evidence supporting its use in mental health diagnostics and therapy. Despite the increasing availability of VR equipment in clinical settings, integration into routine mental health care remains limited. Understanding health care workers' attitudes, knowledge, and perceived barriers is essential for bridging the gap between technological availability and clinical implementation.</p><p><strong>Objective: </strong>This study aimed to investigate health care workers' attitudes toward VR in mental health treatment and identify factors influencing its adoption in settings where VR equipment is already available.</p><p><strong>Methods: </strong>A qualitative study design was used, combining structured one-to-one interviews with a supporting narrative literature review. The narrative review informed the interview design and contextualized findings within the existing evidence base. Structured interviews were conducted with 16 mental health professionals (n=12, 75% women; n=4, 25% men) working in psychiatric and mental health settings in one city in southern Poland where VR equipment was available for patient care. Descriptive statistics summarized closed-ended question responses, and thematic analysis was applied to open-ended questions.</p><p><strong>Results: </strong>Of the 16 participants, 10 (62.5%) had heard of VR technology before and held a favourable view of it, but only 6 (37.5%) were aware of its applications in mental health care. Participants aged under 35 years (6/16) rated the value of VR in therapy more positively than those aged over 50 years (3/16). Among those with prior VR exposure, 85.7% (6/7) expressed confidence in its effectiveness compared with 44.4% (4/9) of those without prior exposure. The most frequently mentioned benefits included interactivity, the ability to individualize therapeutic activities to patient needs, isolated visual and auditory interactions, and an increased sense of patient involvement and control. High costs were identified as the primary barrier by 75% (12/16), and 68.8% (11/16) expressed a need for comprehensive training. Women rated their subjective VR knowledge lower than men despite demonstrating comparable objective knowledge during interviews. VR equipment was described as being restricted within certain service areas. Legal and insurance constraints limited the use of home-based VR.</p><p><strong>Conclusions: </strong>Access to VR equipment alone is insufficient to drive adoption in mental health services. Effective integration requires targeted education, comprehensive training, clear institutional guidelines on equipment responsibility and insurance, and supportive infrastructure. Addressing barriers and knowledge gaps identified in this study is essential for realizing VR's therapeutic potential in routine clinical practice.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e80851"},"PeriodicalIF":3.9,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13625927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082155","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":"Age-Related Differences in Mental Health Status at Psychiatric Discharge: Evidence from 1,106 Patients Across Ten Acute Care Facilities in Alberta, Canada.","authors":"Wanying Mao, Ernest Owusu, Reham Shalaby, Hossam Eldin Elgendy, Belinda Agyapong, Ejemai Eboreime, Peter Silverstone, Pierre Chue, Wes Vuong, Arto Ohinmaa, Andrew J Greenshaw, Vincent I O Agyapong","doi":"10.2196/92360","DOIUrl":"https://doi.org/10.2196/92360","url":null,"abstract":"<p><strong>Background: </strong>The transition from psychiatric inpatient care to community settings is associated with heightened vulnerability and increased risk of adverse mental health outcomes. Understanding age-related differences in mental health status at discharge may inform the targeting of post-discharge interventions and potentially improve longer-term outcomes.</p><p><strong>Objective: </strong>This study examined associations between age and baseline demographic, clinical, and mental health characteristics among participants enrolled in the Text4Support program following discharge from psychiatric inpatient care.</p><p><strong>Methods: </strong>Baseline data from 1,106 participants discharged from inpatient psychiatric units across Alberta, Canada, were analyzed. Participants were grouped by age (18-25 years, 26-40 years, and >40 years). Mental health outcomes were assessed using validated self-report measures. Chi-square tests and one-way ANOVA or Welch's ANOVA were used to examine age-related differences in categorized and continuous outcomes, respectively.</p><p><strong>Results: </strong>Significant age-related differences were observed across several mental health outcomes. Younger participants (18-25 years) reported higher levels of depression, anxiety, and suicidal ideation, along with lower resilience and recovery scores, compared with participants aged >40 years. Differences in quality of life were also observed, with younger adults reporting greater anxiety/depression and participants aged >40 years reporting more mobility-related problems.</p><p><strong>Conclusions: </strong>Marked age-related disparities in mental health status were evident at the point of psychiatric discharge, with younger adults demonstrating greater vulnerability. These findings underscore the importance of age-informed risk stratification and tailored transitional care strategies following inpatient psychiatric treatment and suggest that different strategies may be required depending upon age.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149115882","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":"Physicians' Complex Relationships With Health Information Technology and Burnout: Cross-Sectional Survey Study.","authors":"Mavis Jones, Timothy Jason, Dara Liu, Jeannette Comeau, Chandi Chandrasena, Noni E MacDonald, Janice E Graham","doi":"10.2196/93266","DOIUrl":"10.2196/93266","url":null,"abstract":"<p><strong>Background: </strong>Health information technology (HIT), while designed to improve practice efficiency and patient care, can contribute to physician burnout when designed without clinical practice in mind. Administrative and clinical demands now require physicians to spend more time on HIT, a burden that contributes to burnout and affects time with patients.</p><p><strong>Objective: </strong>This study had two objectives: (1) to examine how physician perceptions of specific HIT functions may alleviate or contribute to physician burnout within the differing health care landscapes of Ontario and Nova Scotia, with particular attention given to physician perceptions of HIT associated with administrative burdens, interoperability, and system integration, and (2) to explore physician experiences and perceptions of HIT as potential factors affecting physician burnout, with the goal of delivering findings (eg, a model) that could be applied to improve physicians' HIT experience.</p><p><strong>Methods: </strong>We designed an exploratory mixed methods study that deployed a cross-sectional survey in 2 Canadian provinces: Ontario and Nova Scotia. Centralized clinician management software (Ontario) and medical association networks (Nova Scotia) were used to recruit from an estimated 35,341 (Ontario) and 2809 (Nova Scotia) physicians. The survey was distributed between February and April 2024. Nonphysician clinicians, clinic staff, and non-HIT users were excluded, resulting in 1245 Ontario and 136 Nova Scotia physician HIT-user respondents. For both the Ontario and Nova Scotia samples, descriptive analyses of quantitative survey items were compared, and open-text responses were subjected to qualitative coding for themes. Subgroup differences in HIT-related burnout were analyzed in the larger Ontario sample.</p><p><strong>Results: </strong>Common experiences were apparent despite differences in the samples, provincial health systems, and available HIT. \"Managing communications related to patient care\" and \"inputting data into your EMR\" were among the top 3 administrative burdens. While \"logging in and out of technology platforms\" ranked higher in Nova Scotia as an administrative burden, the related theme of integration and interoperability was prominent in both samples. In the Ontario sample, perceptions of HIT, quality of support, and hours worked per week accounted for over half of the variation in self-reported burnout.</p><p><strong>Conclusions: </strong>While physicians appreciate the advantages of HIT for patient care, they also experience an overwhelming administrative and documentation burden, as well as disjointedness across data platforms, which contributes to their burnout. Greater ongoing involvement by end users in the design and usability of these technologies, along with improved standardization and interoperability, would reduce these burdens while maintaining the benefits of digital health systems.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e93266"},"PeriodicalIF":3.9,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031423","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":"Shifting Skills in Robot-Assisted Surgery: Case Study With Interdisciplinary Perspectives for Human Factors and Career Research.","authors":"Thomas Ellwart, Julia Birke, Johanna T Paul","doi":"10.2196/87735","DOIUrl":"10.2196/87735","url":null,"abstract":"<p><strong>Background: </strong>The introduction of STARA (smart technology, AI, robotics, and algorithms) changes work processes and the application of skills, depending on specific task design within a given context.</p><p><strong>Objective: </strong>From a Human Factors perspective, this study uses empirical data from a case study to demonstrate how different task designs influence the application of theater nurses' skills during robot-assisted surgeries. Moreover, from a transdisciplinary perspective, the data elucidate that STARA-related task design extends beyond Human Factors' perspectives, encompassing cross-level effects between task configurations of different surgical units and individual evaluations regarding career motives. Finally, the study aims to integrate interdisciplinary perspectives by outlining theoretical, methodological, and practical implications for both STARA-related Human Factors task design in health care and Sustainable Career Research.</p><p><strong>Methods: </strong>Empirical data derive from an embedded single-case study design within a hospital. The case study illustrates field experiences from a focus group interview (n=5) and postsurgery surveys (n=36) on Human Factors-related variables (objective task variety, perceived workload, perceived application of professional skills), and variables from Career Research (perceived career sustainability, growth needs).</p><p><strong>Results: </strong>Higher task variety and skill application during surgeries correlate with long-term career sustainability evaluations. Moreover, career-related growth needs relate to interindividual differences in STARA task evaluations. Interdisciplinary perspectives with respect to theoretical models, practical implications, and methodological challenges are discussed.</p><p><strong>Conclusions: </strong>The introduction of STARA (smart technology, AI, robotics, and algorithms) changes work processes and the application of skills, depending on specific task design within a given context.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e87735"},"PeriodicalIF":3.9,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026245","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":"Understanding Delivery and Engagement With a Digital Self-Management Intervention for Chronic Obstructive Pulmonary Disease Across Two Clinical Settings: Qualitative Study.","authors":"Martin Ruddock, Alison Blythin, Bethany Cliffe, Lucy Yardley, James Dodd, Rachel Williams, Katherine Bradbury, Tom Wilkinson, Ben Ainsworth","doi":"10.2196/88108","DOIUrl":"10.2196/88108","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Adherence to chronic obstructive pulmonary disease (COPD) self-management plans can improve health outcomes, yet access to pulmonary rehabilitation remains limited. Digital self-management interventions, such as &lt;i&gt;myCOPD&lt;/i&gt;, offer a potential means to extend support across care pathways. However, little is known about how these tools are delivered in routine practice or how delivery influences patient engagement across different clinical settings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study explored perceived barriers and facilitators to the delivery of and engagement with &lt;i&gt;myCOPD&lt;/i&gt; by examining the perspectives of both patients and health care professionals (HCPs) across 2 National Health Service settings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This qualitative study was conducted between November 2023 and April 2024 across 2 contrasting clinical pathways: community pulmonary rehabilitation and a hospital discharge service following acute exacerbation of COPD. Semistructured interviews were conducted with patients using &lt;i&gt;myCOPD&lt;/i&gt; and HCPs involved in its delivery. Topic guides covered health background, digital technology use, and experiences of engaging with the intervention. A convenience sampling approach, with elements of purposive sampling, ensured representation across settings. Clinical data were obtained from health records with consent, and usage data were provided by my mhealth Ltd. Data were analyzed using abductive thematic analysis informed by the Medical Research Council's process evaluation framework.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Thirty interviews were completed (16 patients and 14 HCPs). Patients described how multimorbidity, perceived digital ability, and socioeconomic context shaped their engagement with &lt;i&gt;myCOPD&lt;/i&gt;, operating as \"layers of vulnerability\" that influenced whether COPD self-management could be prioritized. HCPs highlighted organizational and workflow constraints that shaped how the intervention was introduced and supported. Delivery approaches differed markedly between settings: community teams adopted proactive, relationship-based support that enabled iterative discussion, tailored recommendations, and continuity, whereas hospital teams described passive, onboarding-focused delivery shaped by time pressures, staffing constraints, and discharge priorities. These contrasting delivery models influenced engagement patterns, with proactive support associated with more &lt;i&gt;multifaceted engagement&lt;/i&gt; (characterized as routine and sustained) and passive onboarding associated with &lt;i&gt;single-aspect engagement&lt;/i&gt; (characterized as short-term and transactional). Participants also identified perceived barriers (eg, usability concerns, limited integration with in-person care) and perceived benefits (eg, improved inhaler technique, increased confidence, lifestyle adjustments).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Delivery context and local workflows play a central role in shaping how pa","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e88108"},"PeriodicalIF":3.9,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13592746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018076","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":"Effects of a Group-Based Cognitive Behavioral Therapy for Sleep in Nursing Students: Pilot Randomized Controlled Trial.","authors":"David Pérez-Manchón, Clara Azpeleta, Beatriz Gal-Iglesias, Cayetana Ruiz Zaldibar","doi":"10.2196/85021","DOIUrl":"10.2196/85021","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Sleep quality is a strategic public health priority and a key factor in the study of circadian rhythms and chronotypes. Nursing students are a particularly vulnerable population group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The objective of this study was to evaluate the effects of a brief group-based cognitive behavioral therapy for insomnia (CBT-I) intervention on sleep quality and circadian-related outcomes among first-year nursing students using ambulatory circadian monitoring.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study is a 2-arm pilot randomized clinical trial conducted at a private university in Madrid, Spain, from October 2022 to March 2023. First-year nursing students aged 18 to 25 years were recruited in October 2022 using convenience sampling and randomly assigned to an experimental group (n=20) that received a cognitive-behavioral intervention using an active-constructive learning methodology to improve sleep quality and a control group (n=20) that followed their usual daily routine. Primary outcomes were objective sleep quality assessed using the Kronowise 3.0 ambulatory circadian monitoring system and subjective sleep quality assessed using the Pittsburgh Sleep Quality Index (PSQI). The objective Kronowise assessment was characterized by the continuous circadian rhythm and sleep parameters generated by the device. Participant satisfaction with the intervention was evaluated using an adapted 12-item Likert-type satisfaction questionnaire administered after the intervention. Measurements were collected preintervention and postintervention over 7-day monitoring periods. Adjusted analyses were performed using analysis of covariance, with treatment group as the fixed factor and baseline values, smoking status, school schedule, and coffee consumption as covariates. Treatment effects were summarized using regression coefficients (β), 95% CIs, and partial eta-squared (η²). The study was conducted in accordance with the CONSORT (Consolidated Standards of Reporting Trials) statement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Forty students (n=34, 85% female; mean age 19.9, SD 1.8 y) were randomized equally into the intervention and control groups. Adjusted analyses showed generally small treatment effects for objective circadian rhythm and sleep outcomes. The largest treatment effect was observed for self-reported sleep latency (β=-19.78 min, 95% CI -33.83 to -5.74; partial η²=0.194). Sleep duration (β=36.32 min, 95% CI -5.01 to 77.64; partial η²=0.086) and sleep efficiency (β=8.75%, 95% CI -0.97 to 18.47; partial η²=0.090) also favored the intervention group, although CIs indicated considerable uncertainty around these estimates. Participants reported high satisfaction with the intervention, with 65% (13/20) rating the program as \"very good.\"&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This pilot randomized controlled trial provides preliminary evidence that a brief group-based CBT-I intervention may improve selected subjective slee","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e85021"},"PeriodicalIF":3.9,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13581143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983027","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":"Cocreating a Digital Patient Preparedness Tool for International Students Accessing Primary Care in Germany: A Convergent Methods Study Within the Health CASCADE Network.","authors":"Vinayak Anand Kumar, Margrit Schreier, Maria Giné-Garriga, Maria Ortmann, Fatima-Zohra Belmokhtar, Simona Grineviciute, Tran Ngoc-Huong Quan, Likhita Aluru, Sonia Lippke","doi":"10.2196/87519","DOIUrl":"10.2196/87519","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Digital health interventions (DHIs) are a potential tool to address communication challenges in primary care medicine by improving patient participation, treatment adherence, and self-management of chronic diseases. However, Germany's digital health infrastructure remains underdeveloped compared to other Organization for Economic Cooperation and Development (OECD) countries. Designing tailored, context-sensitive tools requires a deep understanding of patient needs, particularly for underserved populations navigating complex health care systems. Participatory approaches that actively involve end-users and stakeholders can help ensure that digital health tools are responsive to these needs. Behavioral science frameworks such as the Behavior Change Wheel (BCW), which incorporates the Capability, Opportunity, Motivation-Behavior (COM-B) model, can further support this process. Such technologies, developed using cocreation and behavior change frameworks, may improve health outcomes for underserved patient populations by addressing context-specific needs. This study explores how cocreation and behavioral science can inform the adaptation of a digital patient preparedness tool for international students accessing primary care in Germany.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to gain insight into international students' experiences with primary care in Germany and explore whether adapting an existing digital patient preparedness intervention could address communication challenges and improve the standard of care. Using cocreation methods and the Behavior Change Wheel (BCW), we identified key design specifications and behavior change levers to inform tool development.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A mixed methods design was used to identify design specifications for a DHI across 4 cocreation workshops with 12 students at an international university in Germany. Quantitative data were used for descriptive insights, and qualitative data were analyzed using qualitative content analysis. Workshops were informed by the BCW and the Health CASCADE cocreation methods selector tool.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Cocreators reported feeling misunderstood, anxious, and ill-informed during primary care interactions, with system-level barriers compounding communication difficulties. Despite this, many engaged in preparatory behaviors (eg, note-taking) to manage uncertainty and structure their consultations. Feedback on an existing digital intervention was mixed: while cocreators appreciated its intent, structured lesson formats were seen as too time-consuming. Cocreators preferred a concise, interactive design. Communication prompts, appointment scheduling, and personalized feedback were frequently requested features, though tool adoption was seen as contingent on addressing broader system-level frustrations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;International students' negative health care experiences, often stemming from","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e87519"},"PeriodicalIF":3.9,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13574332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148971628","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":"Public Perceptions and Determinants of Preference for Robotic-Assisted Surgery in the United Arab Emirates: Cross-Sectional Study.","authors":"Yasir Ahmed Mohammed Elhadi, Aminu S Abdullahi, Abdelrahman Mohamed Alblooshi, Abdulla Alhosani, Arwa Al Khalidi, Mohammed Saleem, Shamma Rashed Mohammed Alrashdi, Reem Saleh Aljaberi, Azhar T Rahma","doi":"10.2196/97975","DOIUrl":"10.2196/97975","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Robotic-assisted surgery (RAS) is increasingly being integrated into surgical services worldwide. Successful implementation of robotic surgical technologies depends not only on clinical effectiveness but also on public trust, perceptions of safety, and willingness to use technology-enabled care. In the United Arab Emirates, the adoption of RAS is expanding rapidly; however, evidence regarding public perceptions and factors influencing acceptance remains limited.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to assess awareness, understanding, perceptions, and factors independently associated with preference for RAS among residents in the United Arab Emirates.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A community-based cross-sectional survey was conducted between July and November 2025 among adults aged 18 years or older residing across multiple emirates in the United Arab Emirates. Participants were recruited using a nonprobability convenience sampling approach through hospitals, shopping malls, community events, university mailing lists, and social media platforms. A bilingual Arabic-English questionnaire adapted from previously validated robotic surgery perception instruments was administered. Descriptive statistics summarized participant responses. Associations between participant characteristics and perceptions of RAS were examined using chi-square and Fisher exact tests. To adjust for potential confounding, a multivariable Firth-penalized logistic regression model was fitted to identify factors independently associated with preference for RAS over traditional surgeon-performed surgery. Statistical analyses were conducted using R (version 4.4.1).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 508 participants were included. Although 85% (n=432) had previously heard of RAS, only 38% (n=195) demonstrated an accurate functional understanding of robotic surgical systems. Overall, 33% (n=169) preferred RAS, while 35% (n=178) perceived robotic-assisted procedures as safe. The most frequently reported concerns were robotic malfunction (n=360, 71%), reduced human involvement (n=239, 47%), and procedural costs (n=183, 36%). Perceived benefits included improved surgical precision (n=331, 65%) and reduced complications (n=183, 36%). In multivariable analysis, participants who perceived RAS as safe had substantially higher odds of preferring a robot-assisted surgeon than those who were uncertain about its safety (adjusted odds ratio [aOR]=3.00, 95% CI 1.56-5.87; &lt;i&gt;P&lt;/i&gt;&lt;.001). Conversely, participants who perceived RAS as unsafe had substantially lower odds of preferring a robot-assisted surgeon than those who were uncertain about its safety (aOR=0.08, 95% CI 0.02-0.26; &lt;i&gt;P&lt;/i&gt;&lt;.001). No other factors were independently associated with surgery preference after adjustment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Within this predominantly highly educated convenience sample of United Arab Emirates residents, awareness of RAS was high, bu","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e97975"},"PeriodicalIF":3.9,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13566074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944685","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}