{"title":"Evaluation of a Digital Previsit Tool for Identifying Stroke-Related Health Problems Before a Follow-Up Visit (Part 1): Survey Study.","authors":"Petra Pohl, Karoline Klerfors, Emma K Kjörk","doi":"10.2196/55852","DOIUrl":"10.2196/55852","url":null,"abstract":"<p><strong>Background: </strong>Stroke may lead to various disabilities, and a structured follow-up visit is strongly recommended within a few months after an event. To facilitate this visit, the digital previsit tool \"Strokehealth\" was developed for patients to fill out in advance. The concept Strokehälsa (or Strokehealth) was initially developed in-house as a Windows application, later incorporated in 1177.se.</p><p><strong>Objective: </strong>The study's primary objective was to use a patient satisfaction survey to evaluate the digital previsit tool Strokehealth when used before a follow-up visit, with a focus on feasibility and relevance from the perspective of people with stroke. Our secondary objective was to explore the extent to which the previsit tool identified stroke-related health problems.</p><p><strong>Methods: </strong>Between November 2020 and June 2021, a web-based survey was sent to patients who were scheduled for a follow-up visit after discharge from a stroke unit and had recently filled in the previsit tool. The survey covered demographic characteristics, internet habits, and satisfaction rated using 5 response options. Descriptive statistics were used to present data from both the previsit tool and the survey. We also compared the characteristics of those who completed the previsit tool and those who did not, using nonparametric statistics. Free-text responses were thematically analyzed.</p><p><strong>Results: </strong>All patients filling out the previsit tool (80/171; age: median 67, range 32-91 years) were community-dwelling. Most had experienced a mild stroke and reported a median of 2 stroke-related health problems (range 0-8), and they were significantly younger than nonresponders (P<.001). The survey evaluating the previsit tool was completed by 73% (58/80; 39 men). The majority (48/58, 83%) reported using the internet daily. Most respondents (56/58, 97%) were either satisfied (n=15) or very satisfied (n=41) with how well the previsit tool captured their health problems. The highest level of dissatisfaction was related to the response options in Strokehealth (n=5). Based on the free-text answers to the survey, we developed 4 themes. First, Strokehealth was perceived to provide a structure that ensured that issues would be emphasized and considered. Second, user-friendliness and accessibility were viewed as acceptable, although respondents suggested improvements. Third, participants raised awareness about being approached digitally for communication and highlighted the importance of how to be approached. Fourth, their experiences with Strokehealth were influenced by their perceptions of the explanatory texts, the response options, and the possibility of elaborating on their answers in free text.</p><p><strong>Conclusions: </strong>People with stroke considered the freely available previsit tool Strokehealth feasible for preparing in advance for a follow-up visit. Despite high satisfaction with how well the tool capture","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"11 ","pages":"e55852"},"PeriodicalIF":2.6,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11408892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126880","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}
Sujeong Han, Bumjo Oh, Ho Jun Kim, Seo Eun Hwang, Jong Seung Kim
{"title":"Accelerometer-Based Physical Activity and Health-Related Quality of Life in Korean Adults: Observational Study Using the Korea National Health and Nutrition Examination Survey.","authors":"Sujeong Han, Bumjo Oh, Ho Jun Kim, Seo Eun Hwang, Jong Seung Kim","doi":"10.2196/59659","DOIUrl":"10.2196/59659","url":null,"abstract":"<p><strong>Background: </strong>Health-related quality of life (HRQoL) reflects an individual's perception of their physical and mental health over time. Despite numerous studies linking physical activity to improved HRQoL, most rely on self-reported data, limiting the accuracy and generalizability of findings. This study leverages objective accelerometer data to explore the association between physical activity and HRQoL in Korean adults.</p><p><strong>Objective: </strong>The objective of this study is to analyze the relationship between objectively measured physical activity using accelerometers and HRQoL among Korean adults, aiming to inform targeted interventions for enhancing HRQoL through physical activity.</p><p><strong>Methods: </strong>This observational study included 1298 participants aged 19-64 years from the Korea National Health and Nutrition Examination Survey (KNHANES) VI, who wore an accelerometer for 7 consecutive days. HRQoL was assessed using the EQ-5D questionnaire, and physical activity was quantified as moderate-to-vigorous physical activity accelerometer-total (MVPA-AT) and accelerometer-bout (MVPA-AB). Data were analyzed using logistic regression to determine the odds ratio (ORs) for low HRQoL, adjusting for socioeconomic variables and mental health factors.</p><p><strong>Results: </strong>Participants with higher HRQoL were younger, more likely to be male, single, highly educated, employed in white-collar jobs, and had higher household incomes. They also reported less stress and better subjective health status. The high HRQoL group had significantly more participants meeting MVPA-AB ≥600 metabolic equivalents (P<.01). Logistic regression showed that participants meeting MVPA-AB ≥600 metabolic equivalents had higher odds of high HRQoL (OR 1.55, 95% CI 1.11-2.17). Adjusted models showed consistent results, although the association weakened when adjusting for mental health factors (OR 1.45, 95% CI 1.01-2.09).</p><p><strong>Conclusions: </strong>The study demonstrates a significant association between HRQoL and moderate to vigorous physical activity sustained for at least 10 minutes, as measured by accelerometer. These findings support promoting physical activity, particularly sustained moderate to vigorous activity, to enhance HRQoL. Further interventional studies focusing on specific physical activity domains such as occupational, leisure-time, and commuting activities are warranted.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"11 ","pages":"e59659"},"PeriodicalIF":2.6,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11408890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142120790","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":"Development of a System for Predicting Hospitalization Time for Patients With Traumatic Brain Injury Based on Machine Learning Algorithms: User-Centered Design Case Study.","authors":"Huan Zhou, Cheng Fang, Yifeng Pan","doi":"10.2196/62866","DOIUrl":"10.2196/62866","url":null,"abstract":"<p><strong>Background: </strong>Currently, the treatment and care of patients with traumatic brain injury (TBI) are intractable health problems worldwide and greatly increase the medical burden in society. However, machine learning-based algorithms and the use of a large amount of data accumulated in the clinic in the past can predict the hospitalization time of patients with brain injury in advance, so as to design a reasonable arrangement of resources and effectively reduce the medical burden of society. Especially in China, where medical resources are so tight, this method has important application value.</p><p><strong>Objective: </strong>We aimed to develop a system based on a machine learning model for predicting the length of hospitalization of patients with TBI, which is available to patients, nurses, and physicians.</p><p><strong>Methods: </strong>We collected information on 1128 patients who received treatment at the Neurosurgery Center of the Second Affiliated Hospital of Anhui Medical University from May 2017 to May 2022, and we trained and tested the machine learning model using 5 cross-validations to avoid overfitting; 28 types of independent variables were used as input variables in the machine learning model, and the length of hospitalization was used as the output variables. Once the models were trained, we obtained the error and goodness of fit (R2) of each machine learning model from the 5 rounds of cross-validation and compared them to select the best predictive model to be encapsulated in the developed system. In addition, we externally tested the models using clinical data related to patients treated at the First Affiliated Hospital of Anhui Medical University from June 2021 to February 2022.</p><p><strong>Results: </strong>Six machine learning models were built, including support vector regression machine, convolutional neural network, back propagation neural network, random forest, logistic regression, and multilayer perceptron. Among them, the support vector regression has the smallest error of 10.22% on the test set, the highest goodness of fit of 90.4%, and all performances are the best among the 6 models. In addition, we used external datasets to verify the experimental results of these 6 models in order to avoid experimental chance, and the support vector regression machine eventually performed the best in the external datasets. Therefore, we chose to encapsulate the support vector regression machine into our system for predicting the length of stay of patients with traumatic brain trauma. Finally, we made the developed system available to patients, nurses, and physicians, and the satisfaction questionnaire showed that patients, nurses, and physicians agreed that the system was effective in providing clinical decisions to help patients, nurses, and physicians.</p><p><strong>Conclusions: </strong>This study shows that the support vector regression machine model developed using machine learning methods can accurately pre","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"11 ","pages":"e62866"},"PeriodicalIF":2.6,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11378692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113001","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}
Masooma Hassan, Andre Kushniruk, Elizabeth Borycki
{"title":"Barriers to and Facilitators of Artificial Intelligence Adoption in Health Care: Scoping Review.","authors":"Masooma Hassan, Andre Kushniruk, Elizabeth Borycki","doi":"10.2196/48633","DOIUrl":"10.2196/48633","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) use cases in health care are on the rise, with the potential to improve operational efficiency and care outcomes. However, the translation of AI into practical, everyday use has been limited, as its effectiveness relies on successful implementation and adoption by clinicians, patients, and other health care stakeholders.</p><p><strong>Objective: </strong>As adoption is a key factor in the successful proliferation of an innovation, this scoping review aimed at presenting an overview of the barriers to and facilitators of AI adoption in health care.</p><p><strong>Methods: </strong>A scoping review was conducted using the guidance provided by the Joanna Briggs Institute and the framework proposed by Arksey and O'Malley. MEDLINE, IEEE Xplore, and ScienceDirect databases were searched to identify publications in English that reported on the barriers to or facilitators of AI adoption in health care. This review focused on articles published between January 2011 and December 2023. The review did not have any limitations regarding the health care setting (hospital or community) or the population (patients, clinicians, physicians, or health care administrators). A thematic analysis was conducted on the selected articles to map factors associated with the barriers to and facilitators of AI adoption in health care.</p><p><strong>Results: </strong>A total of 2514 articles were identified in the initial search. After title and abstract reviews, 50 (1.99%) articles were included in the final analysis. These articles were reviewed for the barriers to and facilitators of AI adoption in health care. Most articles were empirical studies, literature reviews, reports, and thought articles. Approximately 18 categories of barriers and facilitators were identified. These were organized sequentially to provide considerations for AI development, implementation, and the overall structure needed to facilitate adoption.</p><p><strong>Conclusions: </strong>The literature review revealed that trust is a significant catalyst of adoption, and it was found to be impacted by several barriers identified in this review. A governance structure can be a key facilitator, among others, in ensuring all the elements identified as barriers are addressed appropriately. The findings demonstrate that the implementation of AI in health care is still, in many ways, dependent on the establishment of regulatory and legal frameworks. Further research into a combination of governance and implementation frameworks, models, or theories to enhance trust that would specifically enable adoption is needed to provide the necessary guidance to those translating AI research into practice. Future research could also be expanded to include attempts at understanding patients' perspectives on complex, high-risk AI use cases and how the use of AI applications affects clinical practice and patient care, including sociotechnical considerations, as more ","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"11 ","pages":"e48633"},"PeriodicalIF":2.6,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11393514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113000","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":"Patients' Expectations of Doctors' Clinical Competencies in the Digital Health Care Era: Qualitative Semistructured Interview Study Among Patients.","authors":"Humairah Zainal, Xin Xiao Hui, Julian Thumboo, Warren Fong, Fong Kok Yong","doi":"10.2196/51972","DOIUrl":"10.2196/51972","url":null,"abstract":"<p><strong>Background: </strong>Digital technologies have impacted health care delivery globally, and are increasingly being deployed in clinical practice. However, there is limited research on patients' expectations of doctors' clinical competencies when using digital health care technologies (DHTs) in medical care. Understanding these expectations can reveal competency gaps, enhance patient confidence, and contribute to digital innovation initiatives.</p><p><strong>Objective: </strong>This study explores patients' perceptions of doctors' use of DHTs in clinical care. Using Singapore as a case study, it examines patients' expectations regarding doctors' communication, diagnosis, and treatment skills when using telemedicine, health apps, wearable devices, electronic health records, and artificial intelligence.</p><p><strong>Methods: </strong>Findings were drawn from individual semistructured interviews with patients from outpatient clinics. Participants were recruited using purposive sampling. Data were analyzed qualitatively using thematic analysis.</p><p><strong>Results: </strong>Twenty-five participants from different backgrounds and with various chronic conditions participated in the study. They expected doctors to be adept in handling medical data from apps and wearable devices. For telemedicine, participants expected a level of assessment of their medical conditions akin to in-person consultations. In addition, they valued doctors recognizing when a physical examination was necessary. Interestingly, eye contact was appreciated but deemed nonessential by participants across all age bands when electronic health records were used, as they valued the doctor's efficiency more than eye contact. Nonetheless, participants emphasized the need for empathy throughout the clinical encounter regardless of DHT use. Furthermore, younger participants had a greater expectation for DHT use among doctors compared to older ones, who preferred DHTs as a complement rather than a replacement for clinical skills. The former expected doctors to be knowledgeable about the algorithms, principles, and purposes of DHTs such as artificial intelligence technologies to better assist them in diagnosis and treatment.</p><p><strong>Conclusions: </strong>By identifying patients' expectations of doctors amid increasing health care digitalization, this study highlights that while basic clinical skills remain crucial in the digital age, the role of clinicians needs to evolve with the introduction of DHTs. It has also provided insights into how DHTs can be integrated effectively into clinical settings, aligning with patients' expectations and preferences. Overall, the findings offer a framework for high-income countries to harness DHTs in enhancing health care delivery in the digital era.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"11 ","pages":"e51972"},"PeriodicalIF":2.6,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11387909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082057","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}
Cheng Kian Tan, Vivian W Q Lou, Clio Yuen Man Cheng, Phoebe Chu He, Veronica Eng Joo Khoo
{"title":"Improving the Social Well-Being of Single Older Adults Using the LOVOT Social Robot: Qualitative Phenomenological Study.","authors":"Cheng Kian Tan, Vivian W Q Lou, Clio Yuen Man Cheng, Phoebe Chu He, Veronica Eng Joo Khoo","doi":"10.2196/56669","DOIUrl":"10.2196/56669","url":null,"abstract":"<p><strong>Background: </strong>This study examined the social well-being of single older adults through the companionship of a social robot, LOVOT (Love+Robot; Groove X). It is designed as a companion for older adults, providing love and affection through verbal and physical interaction. We investigated older adults' perceptions of the technology and how they benefitted from interacting with LOVOT, to guide the future development of social robots.</p><p><strong>Objective: </strong>This study aimed to use a phenomenological research design to understand the participants' experiences of companionship provided by the social robot. Our research focused on (1) examining the social well-being of single older adults through the companionship of social robots and (2) understanding the perceptions of single older adults when interacting with social robots. Given the prevalence of technology use to support aging, understanding single older adults' social well-being and their perceptions of social robots is essential to guide future research on and design of social robots.</p><p><strong>Methods: </strong>A total of 5 single women, aged 60 to 75 years, participated in the study. The participants interacted independently with the robot for a week in their own homes and then participated in a poststudy interview to share their experiences.</p><p><strong>Results: </strong>In total, 4 main themes emerged from the participants' interactions with LOVOT, such as caring for a social robot, comforting presence of the social robot, meaningful connections with the social robot, and preference for LOVOT over pets.</p><p><strong>Conclusions: </strong>The results indicate that single older adults can obtain psychosocial support by interacting with LOVOT. LOVOT is easily accepted as a companion and makes single older adults feel like they have a greater sense of purpose and someone to connect with. This study suggests that social robots can provide companionship to older adults who live alone. Social robots can help alleviate loneliness by allowing single older adults to form social connections with robots as companions. These findings are particularly important given the rapid aging of the population and the increasing number of single-person households in Singapore.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"11 ","pages":"e56669"},"PeriodicalIF":2.6,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11380060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142044154","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}
Hollie Bendotti, Sheleigh Lawler, David Ireland, Coral Gartner, Henry M Marshall
{"title":"Co-Designing a Smoking Cessation Chatbot: Focus Group Study of End Users and Smoking Cessation Professionals.","authors":"Hollie Bendotti, Sheleigh Lawler, David Ireland, Coral Gartner, Henry M Marshall","doi":"10.2196/56505","DOIUrl":"10.2196/56505","url":null,"abstract":"<p><strong>Background: </strong>Our prototype smoking cessation chatbot, Quin, provides evidence-based, personalized support delivered via a smartphone app to help people quit smoking. We developed Quin using a multiphase program of co-design research, part of which included focus group evaluation of Quin among stakeholders prior to clinical testing.</p><p><strong>Objective: </strong>This study aimed to gather and compare feedback on the user experience of the Quin prototype from end users and smoking cessation professionals (SCPs) via a beta testing process to inform ongoing chatbot iterations and refinements.</p><p><strong>Methods: </strong>Following active and passive recruitment, we conducted web-based focus groups with SCPs and end users from Queensland, Australia. Participants tested the app for 1-2 weeks prior to focus group discussion and could also log conversation feedback within the app. Focus groups of SCPs were completed first to review the breadth and accuracy of information, and feedback was prioritized and implemented as major updates using Agile processes prior to end user focus groups. We categorized logged in-app feedback using content analysis and thematically analyzed focus group transcripts.</p><p><strong>Results: </strong>In total, 6 focus groups were completed between August 2022 and June 2023; 3 for SCPs (n=9 participants) and 3 for end users (n=7 participants). Four SCPs had previously smoked, and most end users currently smoked cigarettes (n=5), and 2 had quit smoking. The mean duration of focus groups was 58 (SD 10.9; range 46-74) minutes. We identified four major themes from focus group feedback: (1) conversation design, (2) functionality, (3) relationality and anthropomorphism, and (4) role as a smoking cessation support tool. In response to SCPs' feedback, we made two major updates to Quin between cohorts: (1) improvements to conversation flow and (2) addition of the \"Moments of Crisis\" conversation tree. Participant feedback also informed 17 recommendations for future smoking cessation chatbot developments.</p><p><strong>Conclusions: </strong>Feedback from end users and SCPs highlighted the importance of chatbot functionality, as this underpinned Quin's conversation design and relationality. The ready accessibility of accurate cessation information and impartial support that Quin provided was recognized as a key benefit for end users, the latter of which contributed to a feeling of accountability to the chatbot. Findings will inform the ongoing development of a mature prototype for clinical testing.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"11 ","pages":"e56505"},"PeriodicalIF":2.6,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11369547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005454","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}
Milan Anton Wolf, Leon Sauerwald, Felix Kosmalla, Florian Daiber, Antonio Krüger, Stefan Landgraeber
{"title":"Implementation and Evaluation of a Gait Training Assistant for the Use of Crutches: Usability Study.","authors":"Milan Anton Wolf, Leon Sauerwald, Felix Kosmalla, Florian Daiber, Antonio Krüger, Stefan Landgraeber","doi":"10.2196/51898","DOIUrl":"10.2196/51898","url":null,"abstract":"<p><strong>Background: </strong>Surgical procedures on the lower extremities often require weight-bearing on crutches as part of the rehabilitation process. Orthopedic elective procedures enable patients to learn the correct use of crutches in a controlled preoperative setting. Digital assistance systems can safely circumvent a shortage of skilled staff and any contact restrictions that may be necessary.</p><p><strong>Objective: </strong>The usability of a newly developed gait training assistant (GTA) for the use of crutches will be evaluated. An intervention group trained to use crutches by the digital trainer will be compared with a control group trained to use crutches conventionally by a physiotherapist.</p><p><strong>Methods: </strong>As part of the development and implementation of a novel GTA, 14 patients learned to walk with crutches by completing specific exercises while receiving live feedback. Their movements were detected by a depth sensor and evaluated in real time. Specific parameters (step length, synchronous movement, crutch angle, and crutch distance to the feet) were compared with a control group (n=14) trained to use crutches by physiotherapists. The intervention group was also assessed by a physiotherapist. At the end of the study, the patients completed questionnaires to evaluate the usability of the system (Brooke's System Usability Scale score) and patient satisfaction.</p><p><strong>Results: </strong>All patients trained by the novel GTA were able to use crutches correctly. The intervention group showed significantly better values for crutch angle (mean -6.3°, SD 3.5° vs mean -12.4°, SD 4.5°; P<.001) and crutch position (mean 3.3, SD 5.1 cm vs mean -8.5, SD 4.9 cm; P=.02). Both groups reported that they felt confident in the use of crutches, were able to follow the instructions, and enjoyed the training. Even though the majority (12/14, 86%) preferred physical therapy over a purely digital approach, most participants enjoyed using the system (13/14, 93%) and were interested in trying out other digital assistants (11/14, 79%). The usability of the GTA was rated above average by the majority (9/14, 64%) of the patients.</p><p><strong>Conclusions: </strong>The newly designed GTA is a safe method of teaching the use of crutches and is statistically superior to training by a physiotherapist. Even if patients prefer interaction with a physiotherapist over a purely digital approach, digital devices provide a safe and motivating opportunity to learn the essential locomotor skills for rehabilitation.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"11 ","pages":"e51898"},"PeriodicalIF":2.6,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11364940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989108","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}
Courtney Lyles, Beth Berrean, Ana Buenaventura, Svetlana Milter, Dayana Daniel Hernandez, Urmimala Sarkar, Christian Gutierrez, Nynikka Palmer, William Brown Iii
{"title":"Building a Client Resource and Communication Platform for Community-Based Organizations to Address Health and Social Needs: Co-Design Study.","authors":"Courtney Lyles, Beth Berrean, Ana Buenaventura, Svetlana Milter, Dayana Daniel Hernandez, Urmimala Sarkar, Christian Gutierrez, Nynikka Palmer, William Brown Iii","doi":"10.2196/53939","DOIUrl":"10.2196/53939","url":null,"abstract":"<p><strong>Background: </strong>Connecting individuals to existing community resources is critical to addressing social needs and improving population health. While there is much ongoing informatics work embedding social needs screening and referrals into health care systems and their electronic health records, there has been less focus on the digital ecosystem and needs of community-based organizations (CBOs) providing or connecting individuals to these resources.</p><p><strong>Objective: </strong>We used human-centered design to develop a digital platform for CBOs, focused on identification of health and social resources and communication with their clients.</p><p><strong>Methods: </strong>Centered in the Develop phase of the design process, we conducted in-depth interviews in 2 phases with community-based organizational leadership and staff to create and iterate on the platform. We elicited and mapped participant feedback to theory-informed domains from the Technology Acceptance Model, such as Usefulness and Ease of Use, to build the final product and summarized all major design decisions as the platform development proceeded.</p><p><strong>Results: </strong>Overall, we completed 22 interviews with 18 community-based organizational leadership and staff in 2 consecutive Develop phases. After coding of the interview transcripts, there were 4 major themes related to usability, relevance, and external factors impacting use. Specifically, CBOs expressed an interest in a customer relationship management software to manage their client interactions and communications, and they needed specific additional features to address the scope of their everyday work, namely (1) digital and SMS text messaging communication with clients and (2) easy ways to identify relevant community resources based on diverse client needs and various program eligibility criteria. Finally, clear implementation needs emerged, such as digital training and support for staff using new platforms. The final platform, titled \"Mapping to Enhance the Vitality of Engaged Neighborhoods (MAVEN),\" was completed in the Salesforce environment in 2022, and it included features and functions directly mapped to the design process.</p><p><strong>Conclusions: </strong>Engaging community organizations in user-centered design of a health and social resource platform was essential to tapping into their deep expertise in serving local communities and neighborhoods. Design methods informed by behavioral theory can be similarly employed in other informatics research. Moving forward, much more work will be necessary to support the implementation of platforms specific to CBOs' needs, especially given the resources, training, and customization needed in these settings.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"11 ","pages":"e53939"},"PeriodicalIF":2.6,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11342060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142000883","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}
Saisamhitha Dasari, Bhavya Gopinath, Carter James Gaulke, Sunny Mahendra Patel, Khalil K Merali, Aravind Sunil Kumar, Soumyadipta Acharya
{"title":"A Handheld Tool for the Rapid Morphological Identification of Mosquito Species (VectorCam) for Community-Based Malaria Vector Surveillance: Summative Usability Study.","authors":"Saisamhitha Dasari, Bhavya Gopinath, Carter James Gaulke, Sunny Mahendra Patel, Khalil K Merali, Aravind Sunil Kumar, Soumyadipta Acharya","doi":"10.2196/56605","DOIUrl":"10.2196/56605","url":null,"abstract":"<p><strong>Background: </strong>Malaria impacts nearly 250 million individuals annually. Specifically, Uganda has one of the highest burdens, with 13 million cases and nearly 20,000 deaths. Controlling the spread of malaria relies on vector surveillance, a system where collected mosquitos are analyzed for vector species' density in rural areas to plan interventions accordingly. However, this relies on trained entomologists known as vector control officers (VCOs) who identify species via microscopy. The global shortage of entomologists and this time-intensive process cause significant reporting delays. VectorCam is a low-cost artificial intelligence-based tool that identifies a mosquito's species, sex, and abdomen status with a picture and sends these results electronically from surveillance sites to decision makers, thereby deskilling the process to village health teams (VHTs).</p><p><strong>Objective: </strong>This study evaluates the usability of the VectorCam system among VHTs by assessing its efficiency, effectiveness, and satisfaction.</p><p><strong>Methods: </strong>The VectorCam system has imaging hardware and a phone app designed to identify mosquito species. Two users are needed: (1) an imager to capture images of mosquitos using the app and (2) a loader to load and unload mosquitos from the hardware. Critical success tasks for both roles were identified, which VCOs used to train and certify VHTs. In the first testing phase (phase 1), a VCO and a VHT were paired to assume the role of an imager or a loader. Afterward, they swapped. In phase 2, two VHTs were paired, mimicking real use. The time taken to image each mosquito, critical errors, and System Usability Scale (SUS) scores were recorded for each participant.</p><p><strong>Results: </strong>Overall, 14 male and 6 female VHT members aged 20 to 70 years were recruited, of which 12 (60%) participants had smartphone use experience. The average throughput values for phases 1 and 2 for the imager were 70 (SD 30.3) seconds and 56.1 (SD 22.9) seconds per mosquito, respectively, indicating a decrease in the length of time for imaging a tray of mosquitos. The loader's average throughput values for phases 1 and 2 were 50.0 and 55.7 seconds per mosquito, respectively, indicating a slight increase in time. In terms of effectiveness, the imager had 8% (6/80) critical errors and the loader had 13% (10/80) critical errors in phase 1. In phase 2, the imager (for VHT pairs) had 14% (11/80) critical errors and the loader (for VHT pairs) had 12% (19/160) critical errors. The average SUS score of the system was 70.25, indicating positive usability. A Kruskal-Wallis analysis demonstrated no significant difference in SUS (H value) scores between genders or users with and without smartphone use experience.</p><p><strong>Conclusions: </strong>VectorCam is a usable system for deskilling the in-field identification of mosquito specimens in rural Uganda. Upcoming design updates will address the concerns of user","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"11 ","pages":"e56605"},"PeriodicalIF":2.6,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11364941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989107","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}