JMIR Human Factors最新文献

{"title":"Improving Access to and Delivery of Maternal Health Care Services to Prevent Postpartum Hemorrhage in Selected States in Nigeria: Human-Centered Design Study.","authors":"Bosun Tijani, Uchenna Igbokwe, Temi Filani, Adefemi Adewemimo, Lola Ameyan, Martins Iyekekpolor, Steven Karera, Olatunji Oluyide, Emmanuela Ezike, Temidayo Akinreni, Obruche Ogefere, Victor Adetimilehin, Valentine Amasiatu, Chukwunonso Nwaokorie, Naanma Kangkum, Olufunke Fasawe, Eric Aigbogun","doi":"10.2196/58577","DOIUrl":"10.2196/58577","url":null,"abstract":"<p><strong>Background: </strong>A significant cause of postpartum hemorrhage (PPH) is access to and delivery of maternal health care services. Several multisectoral strategies have been deployed to address the challenges with little success, thereby necessitating the use of human-centered design (HCD) to enhance health care delivery, particularly in PPH management.</p><p><strong>Objective: </strong>This study aims to develop facility-level solutions for optimizing uterotonic supply chain systems and health service delivery in PPH management through an HCD approach in selected Nigerian states.</p><p><strong>Methods: </strong>The research used a four-phase HCD methodology: (1) co-research, (2) co-design, (3) co-refinement, and (4) implementation. However, this paper focused on the first 3 phases. In the co-research phase, 203 interviews were conducted, involving 80 pregnant women and nursing mothers, 97 health care workers, and 26 key stakeholders. Additionally, 33 sites were observed across a 3-level continuum of care. Interviews and focus group discussions revealed insights into the distribution of health workers and observed PPH cases, alongside knowledge and administration of uterotonics. Data analysis was carried out using three key steps: (1) identifying key themes from the collected data, (2) developing insight statements that encapsulate these themes, and (3) translating each insight statement into actionable design opportunities.</p><p><strong>Results: </strong>About 150 ideas were produced and translated into 12 solution prototypes in the co-design phase. Progressive refinement following feedback from 140 stakeholders led to the selection of three final solutions: (1) implementing a referral linkage system to improve the transportation of pregnant women to nearby health facilities, (2) increasing demand for antenatal care services among pregnant women and their families, and (3) delivering a comprehensive uterotonic logistics management program for streamlined uterotonic storage and management.</p><p><strong>Conclusions: </strong>This approach aligns with global health trends advocating for HCD integration in health care programming and aims to empower local champions to drive sustainable improvements in maternal health outcomes. Judicious implementation of the developed prototypes across the states can strengthen clinical care and potentially reduce maternal health service delivery gaps.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"12 ","pages":"e58577"},"PeriodicalIF":2.6,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12077849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040226","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 of Long-Term Physical Activity Measurement With a Wearable Activity Tracker in Patients With Axial Spondyloarthritis: 1-Year Longitudinal Observational Study.","authors":"Emil Eirik Kvernberg Thomassen, Anne Therese Tveter, Inger Jorid Berg, Eirik Klami Kristianslund, Andrew Reiner, Sarah Hakim, Laure Gossec, Gary J Macfarlane, Annette de Thurah, Nina Østerås","doi":"10.2196/68645","DOIUrl":"10.2196/68645","url":null,"abstract":"<p><strong>Background: </strong>Using wearable activity trackers shows promise in measuring physical activity in patients with axial spondyloarthritis (axSpA). However, little is known regarding the feasibility of long-term use.</p><p><strong>Objectives: </strong>This study aimed to explore the feasibility of recording physical activity using a wearable activity tracker and describe wear-time patterns among patients with axSpA.</p><p><strong>Methods: </strong>Data from a randomized controlled trial (NCT: 05031767) were analyzed. Patients with axSpA and low disease activity were recruited from an outpatient clinic and asked to wear a Garmin vívosmart 4 activity tracker for 1 year. The activity tracker measured steps and heart rate. Trial feasibility (eligibility, inclusion rate, and patient characteristics), technical feasibility (data recorded, tracker adherence, ie, days worn, and missing data), and operational feasibility (synchronization reminders and tracker replacements) were analyzed. Tracker adherence was calculated as the percentage of recorded minutes of the maximum possible minutes. Unsupervised hierarchical clustering was used to explore tracker wear-time patterns.</p><p><strong>Results: </strong>Of the 160 patients screened, 75 (47%) agreed to use the tracker and 64 (85%) were analyzed (11 had insufficient data). The median activity tracker adherence over 1 year was 66% (IQR 30-86). There was 30% missing step and 0.01% heart rate data in the physical activity dataset. A median of 18 (IQR 9-25) reminders per patient to synchronize activity data were distributed. Analysis of wear-time patterns resulted in 3 groups: Adherent (33/64, 51% of patients), Minimal Use (17/64, 27%), and Intermittently adherent (14/64, 22%).</p><p><strong>Conclusions: </strong>Trial feasibility was low, while technical and operational feasibility were acceptable. Only 51% of the patients were highly adherent. Activity trackers, though trendy, have low to moderate feasibility over 1 year in patients with axSpA. Automated synchronization and adherence barriers should be further explored.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"12 ","pages":"e68645"},"PeriodicalIF":2.6,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12077851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989284","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":"Building and Beta-Testing Be Well Buddy Chatbot, a Secure, Credible and Trustworthy AI Chatbot That Will Not Misinform, Hallucinate or Stigmatize Substance Use Disorder: Development and Usability Study.","authors":"Adam Jerome Salyers, Sheana Bull, Joshva Silvasstar, Kevin Howell, Tara Wright, Farnoush Banaei-Kashani","doi":"10.2196/69144","DOIUrl":"10.2196/69144","url":null,"abstract":"<p><strong>Background: </strong>Artificially intelligent (AI) chatbots that deploy natural language processing and machine learning are becoming more common in health care to facilitate patient education and outreach; however, generative chatbots such as ChatGPT face challenges, as they can misinform and hallucinate. Health care systems are increasingly interested in using these tools for patient education, access to care, and self-management, but need reassurances that AI systems can be secure and credible.</p><p><strong>Objective: </strong>This study aimed to build a secure system that people can use to send SMS with questions about substance use, and which can be used to screen for substance use disorder (SUD). The system will rely on data transfer via third party vendors and will thus require reliable and trustworthy encryption of protected health information .</p><p><strong>Methods: </strong>We describe the process and specifications for building an AI chatbot that users can access to gain information on and screen for SUD from Be Well Texas, a clinical provider affiliated with the University of Texas Health Sciences Center at San Antonio.</p><p><strong>Results: </strong>The AI chatbot system uses natural language processing and machine learning to classify expert-curated content related to SUD. It illustrates how we can comply with best practices in HIPPA (Health Insurance Portability and Accountability Act) compliance in data encryption for data transfer and data at rest, while still offering a state-of-the-art system that uses dynamic, user-driven conversation to dialogue about SUD, screen for SUD and access SUD treatment services.</p><p><strong>Conclusions: </strong>Recent calls for attention to user-friendly design concerning user rights that honor digital rights and regulations for digital substance use offerings suggest that this study is timely and appropriate while still advancing the field of AI.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"12 ","pages":"e69144"},"PeriodicalIF":2.6,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12077853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062730","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":"Optimizing Clinical Decision Support System Functionality by Leveraging Specific Human-Computer Interaction Elements: Insights From a Systematic Review.","authors":"Ali Azadi, Francisco José García-Peñalvo","doi":"10.2196/69333","DOIUrl":"10.2196/69333","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Clinical decision support systems (CDSSs) play a pivotal role in health care by enhancing clinical decision-making processes. These systems represent a significant advancement in medical information systems. However, optimizing their effectiveness requires accounting for various human-computer interaction (HCI) elements that influence their functionality and user acceptance.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to identify and categorize key HCI elements that impact CDSS performance to enhance system usability, adaptability, and decision-making accuracy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a systematic literature review, identifying 923 studies from the databases PubMed, Scopus, and Web of Science. Papers were screened and selected based on predefined inclusion criteria. A rigorous quality assessment process was applied to ensure the relevance and reliability of the included studies. Ultimately, of the 923 papers identified, 43 (4.7%) that specifically addressed HCI elements applicable to CDSS environments were included in the final analysis. Data extraction and synthesis were performed to answer the research questions regarding HCI elements.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 12 distinct HCI elements were identified, each with the potential to influence CDSS functionality. These elements align with the International Organization for Standardization (ISO) 9241-11 framework, which defines usability in terms of effectiveness, efficiency, and satisfaction. \"User satisfaction,\" \"flexibility,\" and \"individuality\" enhance satisfaction by improving system adaptability and user acceptance. \"Visibility,\" \"explainability,\" and \"user control\" strengthen effectiveness by supporting decision-making and error prevention. \"Ease of use\" improves efficiency by streamlining interactions and reducing cognitive load. Some elements influence effectiveness and efficiency, such as \"data entry,\" which ensures structured inputs for decision accuracy while optimizing workflows. Likewise, \"alerts\" provide timely information for effective decision-making and, simultaneously, are designed to avoid overwhelming users and maintain system efficiency. \"Simplification\" and \"mental effort\" also optimize workflows and reduce complexity. Furthermore, \"interface\" impacts effectiveness and efficiency by supporting accurate decision-making and streamlining user interaction. This categorization, aligned with ISO 9241-11, underscores the context and task dependency of usability, highlighting that HCI elements must be adapted to different user needs and environments for effective clinical decision-making.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study addresses a critical gap in CDSS research by offering a comprehensive framework of HCI elements tailored to the CDSS environment. Incorporating these elements into system design can improve user satisfaction, reduce data errors, and enhance the accuracy of medical decisions. The ","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"12 ","pages":"e69333"},"PeriodicalIF":2.6,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001341","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":"Knowledge Sharing Maturity Model for Medical Imaging Departments: Development Study.","authors":"Maryam Almashmoum, James Cunningham, John Ainsworth","doi":"10.2196/54484","DOIUrl":"10.2196/54484","url":null,"abstract":"<p><strong>Background: </strong>Knowledge sharing in medical imaging departments is driven by the need to improve health care services, develop health care professionals' skills, and reduce repetitive mistakes. It is considered an important step in the implementation of knowledge management solutions. By following a maturity model of knowledge sharing, knowledge-sharing practices can be improved.</p><p><strong>Objective: </strong>This study aimed to develop a maturity model for knowledge sharing in the medical imaging department to help managers to assess the level of maturity of knowledge-sharing practices. In modern health care institutions, improvements in health care professionals' skills and health care services are often driven through practicing knowledge-sharing behaviors. Managers can follow the indicators of maturity model of knowledge sharing and its measurements to identify the current level and move to the next level.</p><p><strong>Methods: </strong>This study was conducted in 4 stages: an overview stage that highlighted the factors that affect knowledge-sharing practices in medical imaging departments; an analysis factor stage that was designed to assess the factors that affect knowledge sharing using a concurrent mixed methods approach (questionnaires and semistructured interviews) in 2 medical imaging departments; a structuring maturity model knowledge sharing stage, where a maturity model of knowledge sharing was developed based on the findings of the first and second stages; and finally, an assessment of reliability and validity stage, where a modified Delphi method was used to obtain consensus among experts on model components to be ready for implantation.</p><p><strong>Results: </strong>The model presented in this study includes 17 indicators, divided into 11 components. Those components were derived from the findings of the questionnaires and semistructured interviews that were applied in the medical imaging departments. It consisted of 5 maturity levels: initial, aware, defined, managed, and optimized. In each level, measurements were included to help managers assess the current level by answering the questions. On the basis of reliability, the experts reached a consensus agreement on the model's components in 2 rounds with SD <1.</p><p><strong>Conclusions: </strong>This maturity model of knowledge sharing in medical imaging departments allows managers and policy makers to measure the maturity level of knowledge sharing in those departments. Although the model has been applied to medical imaging departments, it could easily be modified for application in other institutions.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"12 ","pages":"e54484"},"PeriodicalIF":2.6,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038528","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":"Co-Designing, Developing, and Testing a Mental Health Platform for Young People Using a Participatory Design Methodology in Colombia: Mixed Methods Study.","authors":"Laura Ospina-Pinillos, Débora L Shambo-Rodríguez, Mónica Natalí Sánchez-Nítola, Alexandra Morales, Laura C Gallego-Sanchez, María Isabel Riaño-Fonseca, Andrea Carolina Bello-Tocancipá, Alvaro Navarro-Mancilla, Jaime A Pavlich-Mariscal, Alexandra Pomares-Quimbaya, Carlos Gómez-Restrepo, Ian B Hickie, Jo-An Occhipinti","doi":"10.2196/66558","DOIUrl":"10.2196/66558","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Globally, mental health (MH) problems increasingly affect young people, contributing significantly to disability and disease. In low- and middle-income countries, such as Colombia, barriers to accessing care exacerbate the treatment gap. In addition, the lack of widespread digital interventions further deepens the digital health divide between the Global North and Global South, limiting equitable access to innovative MH solutions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to co-design and develop an MH platform using participatory design methodologies and conduct a 15-month naturalistic observational trial to assess its feasibility among Colombian youth.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study used a mixed methods approach within a structured research and development cycle. To ensure a user-centered design, we began with a series of co-design workshops, where stakeholders collaboratively identified key user needs. Following this, usability testing was conducted in 2 stages, alpha and beta, using the System Usability Scale (SUS) to assess functionality and user experience. To capture real-world interactions, a naturalistic observational trial ran from July 2022 to October 2023, collecting data on user engagement and system performance. This study integrated quantitative and qualitative analyses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 146 individuals participated in the co-design process, with 110 (75.3%) contributing to the development of platform components and 36 (24.7%) participating in usability testing. The co-designed platform integrated several key features, including social media and advertising, an MH screening tool, registration, targeted psychoeducational resources, automated tailored recommendations, and a \"track-as-you-go\" feature for continuous MH monitoring. Additional elements included user-friendly follow-up graphs, telecounseling integration, customizable well-being nudges, an emergency button, and gamification components to enhance engagement. During usability testing, the beta prototype received a median SUS score of 85.0 (IQR 80-92.5), indicating high usability. In the subsequent observational trial, which ran from July 2022 to October 2023, a total of 435 users interacted with the platform-314 (72.2%) as registered users and 121 (27.8%) anonymously. Emotional distress was prevalent, with 63.7% (200/314) of the registered users and 61.2% (74/121) of the anonymous users reporting distress, as measured by the 6-item Kessler Psychological Distress Scale. Despite 102 users requesting telecounseling, only 26.5% (27/102) completed a session. While usability scores remained high, engagement challenges emerged, with only 18.8% (59/314) of the users continuing platform use beyond the first day.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study explored the development and user experience of a youth MH platform in Colombia, demonstrating that a cocreation approach is both feasible and effectiv","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"12 ","pages":"e66558"},"PeriodicalIF":2.6,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037058","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":"Employee Preference and Use of Employee Mental Health Programs: Mixed Methods Study.","authors":"Benedict Sevov, Robin Huettemann, Maximillian Zinner, Sven Meister, Leonard Fehring","doi":"10.2196/65750","DOIUrl":"10.2196/65750","url":null,"abstract":"<p><strong>Background: </strong>Mental health issues represent a prevalent challenge for employees and their employers, leading to substantial impacts on individuals, society, and the economy. Different employee mental health programs (EMHPs) can support employees in preventing and treating mental health issues. However, the impact of such EMHPs depends largely on the use behavior of employees.</p><p><strong>Objective: </strong>This study aimed to gain deeper insights into employees' attitude and use behavior regarding EMHPs by investigating (1) employee preference and intention to use EMHPs, (2) factors that predict use, and (3) key facilitators and barriers influencing use.</p><p><strong>Methods: </strong>An exploratory sequential mixed methods approach was applied, including a scoping review, qualitative interviews, and a quantitative web-based survey. Semistructured qualitative interviews were conducted with 15 employees to gain insights into EMHPs from the employee perspective and inform the creation of a web-based questionnaire. The quantitative web-based survey was conducted to collect representative primary data on employees' perspectives on different EMHPs using 7-point Likert scales. The collected quantitative data were analyzed through descriptive and inferential statistics, including repeated measures ANOVAs and chi-square tests.</p><p><strong>Results: </strong>The final sample of the web-based survey consisted of 1134 participants and was representative across several sociodemographic characteristics. Analysis of the sample revealed that when given the choice, employees preferred digital (n=666, 58.73%) and self-intervention (n=590, 52.03%) EMHPs. Employees were most likely to use EMHPs focused on prevention (mean 4.89, SD 1.61). Intention to use EMHPs was predicted by age (young: mean 4.59, SD 1.2; old: mean 4.19, SD 1.4; P<.001; Cohen d=0.32), education (academic degree: mean 4.68, SD 1.24; no academic degree: mean 4.26, SD 1.32; P<.001; Cohen d=0.32), and mostly by company culture (positive company culture: mean 4.61, SD 1.27; negative company culture: mean 3.99, SD 1.27; P<.001; Cohen d=0.49). Cost coverage (n=345, 30.42%) and ease of use (n=337, 29.72%) were critical facilitators of use.</p><p><strong>Conclusions: </strong>Employers can have a positive contribution to employee mental health by starting to offer EMHPs, preferably digital self-intervention programs for prevention; creating and maintaining the right work environment and culture; and ensuring cost coverage for the EMHP.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"12 ","pages":"e65750"},"PeriodicalIF":2.6,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022584","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":"Adapting a Text Messaging Intervention to Improve Diabetes Medication Adherence in a Spanish-Speaking Population: Qualitative Study.","authors":"Jacqueline Seiglie, Seth Tobolsky, Ricaurte Crespo Trevino, Lluvia Cordova, Sara Cromer, A Enrique Caballero, Margarita Alegria, J Jaime Miranda, Deborah Wexler, Lindsay Mayberry","doi":"10.2196/66668","DOIUrl":"https://doi.org/10.2196/66668","url":null,"abstract":"<p><strong>Background: </strong>Latino adults with type 2 diabetes (T2D) have higher rates of diabetes medication nonadherence than non-Hispanic White adults. REACH (Rapid Encouragement/Education And Communications for Health) is a text message platform based on the information-motivation-behavioral skills model that addresses barriers to adherence and was shown to improve adherence and glycated hemoglobin (HbA1c) levels, but it is only available in English.</p><p><strong>Objective: </strong>This study aimed to report the multiphase, stakeholder-driven adaptation of the REACH barriers to diabetes medication adherence content to a Latino population (REACH-Español).</p><p><strong>Methods: </strong>This was a qualitative study using focus groups. We identified potentially eligible patients (≥18 y old, Latino ethnicity, Spanish-language preference, and T2D diagnosis) using a Mass General Brigham Hospital query. Eligible patients were invited to participate in a focus group conducted in Spanish between April 13 and November 9, 2023. A total of 5 focus groups were conducted. Focus groups 1-3 centered on ranking 40 barriers to diabetes medication adherence (derived from REACH and the extant literature), whereas focus groups 4-5 centered on translation and cultural modifications of the original SMS text message content associated with each of the REACH barriers. Barriers were mapped onto information-motivation-behavioral constructs. We used descriptive statistics to summarize participant characteristics. Focus groups were audio-recorded, professionally transcribed, and analyzed with thematic content analysis using NVivo (Lumivero).</p><p><strong>Results: </strong>In total, 22 participants attended the focus groups. The mean (SD) age was 63.2 (11) years, 55% (n=10/22) were female, and the mean HbA1c level was 8.5%. All participants were born in Latin America or the Caribbean and spoke Spanish as their preferred language, and 54.5% (12/22) had completed middle-school education or less. Among the top 10 ranked barriers, 50% (n=5) corresponded to information, 20% (n=2) to social motivation, 20% (n=2) to behavioral skills, and 10% (n=1) to personal motivation. Personal motivation barriers (medication burden and fear of side effects) and behavioral skills (forgetting to take medication) emerged as important themes in the focus groups.</p><p><strong>Conclusions: </strong>A stakeholder-driven approach to intervention adaptation identified and prioritized relevant barriers to diabetes medication adherence among Latino adults with T2D and facilitated the adaptation of the REACH platform to a Spanish-speaking population.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"12 ","pages":"e66668"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048175","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":"Immersive Virtual Reality eHealth Intervention to Reduce Anxiety and Depression in Pregnant Women: Randomized Controlled Trial.","authors":"Marta Jimenez-Barragan, Amparo Del Pino Gutierrez, Gloria Sauch Valmaña, Olga Monistrol, Carme Monge Marcet, Mar Pallarols Badia, Ignasi Garrido, Anna Carmona Ruiz, Oriol Porta Roda, Cristina Esquinas, Gemma Falguera Puig","doi":"10.2196/71708","DOIUrl":"10.2196/71708","url":null,"abstract":"<p><strong>Background: </strong>Mental health during pregnancy is a critical factor influencing maternal and fetal outcomes. Anxiety and depression affect up to 30% of pregnant women, with significant consequences for maternal well-being and child development. Despite this, interventions during pregnancy remain limited, creating a need for innovative, accessible solutions.</p><p><strong>Objective: </strong>This study aimed to evaluate the effectiveness of an immersive virtual reality (IVR) eHealth intervention in reducing anxiety and depression symptoms in women during pregnancy.</p><p><strong>Methods: </strong>A 2-arm, randomized controlled trial was conducted across 5 primary care centers in Catalonia, Spain, between October 2021 and May 2024. The study included pregnant women (N=70) aged ≥18 years with moderate anxiety and depression symptoms (Edinburgh Postnatal Depression Scale [EPDS] scores: 9-12) at 12 to 14 weeks of gestation. They were randomly assigned (1:1) to an IVR intervention or standard care group. The intervention group engaged in daily 14-minute IVR mindfulness and relaxation sessions for 6 weeks. Mental health outcomes were assessed using the EPDS and State-Trait Anxiety Inventory.</p><p><strong>Results: </strong>The intervention group demonstrated significant reductions in EPDS scores, with a mean decrease from 11.32 (SD 0.96) to 7.25 (SD 1.32; P<.001), compared to an increase in the control group from 11.32 (SD 0.94) to 16.23 (SD 1.25; P<.001). Similarly, State-Trait Anxiety Inventory scores improved markedly in the intervention group (mean decrease from 57.94, SD 5.23 to 35.03, SD 6.12; coefficient -30.47, 95% CI -45.23 to -15.72; P<.001), while the control group experienced a nonsignificant increase (from 66.10, SD 5.89 to 72.91, SD 6.34; P=.68). High adherence rates were observed, with 79% (26/33) of participants completing ≥30 sessions. Participant satisfaction was high, with 87% (29/33) reporting being \"very satisfied\" with the intervention.</p><p><strong>Conclusions: </strong>The IVR eHealth intervention significantly reduced symptoms of anxiety and depression, demonstrating its potential as an accessible and effective tool for mental health support during pregnancy. High adherence and satisfaction levels underscore its feasibility and acceptability. Future research should explore the long-term effects and scalability of IVR interventions in diverse settings.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT05756205; https://clinicaltrials.gov/study/NCT05756205.</p><p><strong>International registered report identifier (irrid): </strong>RR2-10.1186/s12912-023-01440-4.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"12 ","pages":"e71708"},"PeriodicalIF":2.6,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12079065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044443","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":"Correction: Patient Experiences With a Mobile Self-Care Solution for Low-Complex Orthopedic Injuries: Mixed Methods Study.","authors":"Jelle Spierings, Gijs Willinge, Marike Kokke, Sjoerd Repping, Wendela de Lange, Thijs Geerdink, Ruben van Veen, Detlef van der Velde, J Carel Goslings, Bas Twigt","doi":"10.2196/75812","DOIUrl":"https://doi.org/10.2196/75812","url":null,"abstract":"","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"12 ","pages":"e75812"},"PeriodicalIF":2.6,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062731","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}