JMIR Human Factors最新文献

{"title":"Usability and User Experience Assessment of Health Care Conversational Agents Using Validated Subjective Instruments: Systematic Review and Comparative Analysis.","authors":"João Pavão, Rute Bastardo, Anabela Gonçalves Silva, Nelson Pacheco Rocha","doi":"10.2196/102911","DOIUrl":"10.2196/102911","url":null,"abstract":"<p><strong>Background: </strong>Digital applications based on health care conversational agents (HCAs) are increasingly being developed to support health care provision. The usability and user experience of these solutions are critical determinants of their acceptability and, consequently, their impact on health-related outcomes.</p><p><strong>Objective: </strong>This systematic review aims to synthesize current evidence on the use of valid and reliable subjective instruments for assessing the usability and user experience of HCAs and to examine whether assessment outcomes vary according to their technical characteristics.</p><p><strong>Methods: </strong>A systematic search was conducted in PubMed, Web of Science, and Scopus from inception to February 2026. Studies were included if they used subjective instruments to evaluate the usability or user experience of HCAs.</p><p><strong>Results: </strong>A total of 127 studies met the inclusion criteria. The studies examined 3 categories of HCAs-text-based, voice-based, and embodied-applied to patient care, health education and prevention, health data collection, and support for daily activities among older adults. The System Usability Scale (SUS) was the most frequently used assessment instrument. Comparative analysis of SUS scores indicated higher usability ratings for text-based HCAs relative to voice-based and embodied systems. However, SUS and other subjective instruments used in the included studies may not fully capture key dimensions of usability and user experience of HCAs. Additionally, substantial heterogeneity was observed in assessment methodologies across studies.</p><p><strong>Conclusions: </strong>Comparative analysis suggested that text-based HCAs were associated with significantly higher SUS scores than voice-based and embodied HCAs. However, this finding should be interpreted with caution given the substantial heterogeneity across the included studies in health care application domains, study designs, evaluation contexts, participant populations, and HCAs' implementation and use characteristics, as well as the limitations of the SUS in evaluating the usability of modern HCAs. The variability in assessment approaches underscores the need for standardized protocols and the development of more context-specific evaluation frameworks to enhance methodological consistency and comparability across studies.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e102911"},"PeriodicalIF":3.9,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621719","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":"Sentence-Level Provenance for AI Medical Record Summarization: Formative Usability Evaluation of a Click-to-Inspect Interface.","authors":"Andrew Parambath, Giordana Pulpo, Vince Hartman","doi":"10.2196/95644","DOIUrl":"https://doi.org/10.2196/95644","url":null,"abstract":"<p><strong>Background: </strong>Large language models (LLMs) can generate fluent summaries of longitudinal medical records, but in high-stakes clinical settings, verification burden remains a barrier to trust. Existing provenance mechanisms, such as document-level citations and section references, often require manual search within long, fragmented notes, limiting their usefulness during time-constrained workflows for clinicians.</p><p><strong>Objective: </strong>To design and evaluate a sentence-level provenance interface (\"click-to-inspect\") that enables rapid verification of AI-generated longitudinal medical record summaries at the level of individual statements.</p><p><strong>Methods: </strong>Between November 2023 and January 2024, we conducted a formative usability study using remote moderated usability sessions via Zoom to evaluate a web-based sentence-level provenance interface for AI-generated longitudinal medical record summaries. A convenience sample of clinicians was recruited through email outreach to academic and professional networks across the United States. Formative usability testing was conducted with 46 clinician interactions using synthetic longitudinal patient charts. Participants included medical students, residents, and attending physicians across multiple specialties including internal medicine, dermatology, radiology, plastic surgery, anesthesiology, interventional radiology, obstetrics-gynecology, and family medicine. Usability was assessed using the System Usability Scale (SUS) and Net Promoter Score (NPS), alongside qualitative feedback.</p><p><strong>Results: </strong>Clinicians reported high usability (mean SUS score 86.25, SD 7.77; 95% CI 83.96-88.54 from 46 participants) and a positive overall experience (NPS 35; 22/46 promoters, 18/46 passives, 6/46 detractors). Participants described rapid access to supporting evidence as critical for trust calibration during first-pass chart review. Qualitative feedback identified friction in traditional citation-based interfaces and supported sentence-level inspectability as a low-friction verification mechanism.</p><p><strong>Conclusions: </strong>Sentence-level provenance transforms AI-generated summaries from static narratives into interactive verification tools. An approach that enables rapid, selective inspection of individual claims during longitudinal chart review, may reduce verification burden and support calibrated reliance in high-risk clinical contexts.</p><p><strong>Clinicaltrial: </strong></p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148631946","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":"Feasibility of a Mobile-Based Home Monitoring System for Patients With Heart Failure: Mixed Methods Pilot Study.","authors":"Finna E Indriany, Kemal N Siregar, Bambang Budi Siswanto, Budhi Setianto Purwowiyoto, Rarsari Soerarso, Indrajani Sutedja, Benny Setiawan, Hendy R Wijaya, Raymond Ching Chiew Wong, Salvatore Di Somma, Peter MacDonald","doi":"10.2196/84309","DOIUrl":"10.2196/84309","url":null,"abstract":"<p><strong>Background: </strong>The risk of rehospitalization in patients with heart failure (HF) has initiated various efforts to prevent and simultaneously improve quality of life. Self-monitoring at home is one option, and technology is increasingly being used for this purpose.</p><p><strong>Objective: </strong>This pilot study aimed to evaluate the feasibility and preliminary effects of a digital home monitoring intervention on patient-reported outcomes and 30-day readmissions among patients with HF in Indonesia.</p><p><strong>Methods: </strong>A mixed methods pilot study was conducted, combining qualitative system development and quantitative evaluation. Patients were assigned to an intervention group (digital monitoring) or control group (standard care). Readmission rates were compared using chi-square tests and odds ratios. Changes in Kansas City Cardiomyopathy Questionnaire scores were analyzed using linear mixed-effects models.</p><p><strong>Results: </strong>A total of 60 patients were included (n=30, 50% in the intervention group; n=30, 50% in the control group). Readmission occurred in 20% (6/30) of patients in the intervention group and 43.3% (13/30) of patients in the control group (odds ratio 0.33, 95% CI 0.10-1.09; P=.10). Linear mixed-effects analysis showed greater improvement in Kansas City Cardiomyopathy Questionnaire overall summary score in the intervention group (P=.02). Improvements were observed in the physical limitation, symptom frequency, symptom burden, quality of life, and social limitation domains. During follow-up, 3.3% (1/30) of the patients in the intervention group died of non-HF-related causes, and 10% (3/30) of the patients in the control group died due to HF.</p><p><strong>Conclusions: </strong>This pilot study suggests that digital home monitoring is feasible and associated with improvements in patient-reported outcomes, with a potential signal toward reduced readmission. Larger studies are needed to confirm effectiveness.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e84309"},"PeriodicalIF":3.9,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13431228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621735","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":"Barriers to Population Data Use in Overdose Fatality Reviews: Observational and Interview Study of Dashboard Deployment.","authors":"Amey Salvi, Cynthia Holladay, Allyson L Dir, Bradley Ray, Matthew C Aalsma, Khairi Reda","doi":"10.2196/98864","DOIUrl":"10.2196/98864","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Overdose fatality reviews (OFRs) are an important public health tool for developing local overdose prevention strategies by reviewing individual overdose cases. While this approach offers a rich, contextual understanding of drug overdose factors in communities, it examines a small number of cases, providing limited insight into broader population-level risk patterns. To complement OFRs, we developed a real-time dashboard that visualizes trends about 5 key \"touchpoints\" (ie, interactions with medical and justice services preceding overdose). We then trained local OFR teams to use this dashboard to identify prevention opportunities.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study examines the integration of population-level data into OFR practices, as well as the tensions that emerge between OFRs' traditional case-driven review processes and the statistical, population-level analysis typical in public health. We analyze how and when the dashboard was used in meetings, determine the extent to which the data informed recommendations, and identify barriers that prevented the broad uptake of this intervention.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We observed 26 OFR meetings across 11 counties in Indiana over 10 months, from November 2024 to September 2025, during which teams conducted case reviews and developed recommendations. We documented instances of dashboard use as well as \"missed opportunities,\" in which relevant population-level data were available but not incorporated into the discussion. We also conducted semistructured interviews with OFR team members (n=7) to understand their perceptions of the dashboard, including its usefulness, usability, and adoption barriers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Despite its intended role, the dashboard was rarely integrated into OFR meetings; it was used only 10 times, compared to 114 missed opportunities in which relevant data could have informed discussions. Interviews revealed that this limited uptake was not solely due to usability barriers but reflected a deeper tension between 2 distinct analytic approaches. OFR teams prioritized narrative-driven case reviews that were grounded in empathy, local knowledge, and lived experience. This approach seemed at odds with the population-level visualizations shown in the dashboard, which required statistical abstraction and interpretation. Other barriers identified included limited time and resources, staff turnover, and varying levels of data fluency, which made it difficult for teams to confidently interpret the dashboard despite training.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The results highlight a tension between case-based and data-driven approaches to overdose prevention. These approaches are grounded in different workflows, values, and motivations, making it challenging for OFR teams to maintain their traditional, empathetic review practices while incorporating population-level trends. Our findings indicate the need for data tools th","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e98864"},"PeriodicalIF":3.9,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13404934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608123","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":"Process Evaluation of Digital Mental Health Interventions for Psychosis: Scoping Review With Framework Synthesis.","authors":"Chloe Hampshire, Charlotte Dack, Shadi Daryan, Carolina Fialho, Rayan Taher, Ashley-Louise Teale, Jenny Yiend, Pamela Jacobsen","doi":"10.2196/88032","DOIUrl":"10.2196/88032","url":null,"abstract":"<p><strong>Background: </strong>Implementing digital mental health interventions (DMHI) for those with psychosis is a persistent challenge. A process evaluation, or studies conducted alongside trials, is one research method that may address this issue. However, a synthesis of process evaluation data in this area is missing.</p><p><strong>Objective: </strong>This study aimed to understand what is known about context, implementation, and mechanisms of impact by synthesizing process evaluation data from trials evaluating DMHIs used by people with psychosis.</p><p><strong>Methods: </strong>A scoping review using a 2-phase search strategy underpinned by the Medical Research Council (MRC) process evaluation framework was conducted. Database searches of Cochrane Central Register of Controlled Trials and PsycInfo in 2024 and 2025 first identified an index sample of peer-reviewed trials predominantly conducted in the United Kingdom (≥50% of samples from the United Kingdom in multicountry studies). Next, papers linked to the index sample were retrieved and included if they reported process evaluation data as operationalized in the MRC framework. Two authors independently screened references, extracted summary data, and assessed the quality of index trials. One author qualitatively synthesized process evaluation data using a deductive framework synthesis approach using the MRC framework. Findings were triangulated with senior authors and presented as a narrative synthesis.</p><p><strong>Results: </strong>Searches identified 14 DMHIs and 45 papers reporting process evaluation data, though only 2 were labeled as such. Qualitative syntheses of process evaluation data generated five themes aligned with the MRC framework: (1) enhancing fit and supporting delivery (implementation strategies); (2) DMHI implementation varied across users, staff, and delivery settings (implementation outcomes); (3) helping users to respond in more helpful ways (mechanisms); (4) addressing perceived and actual implementation factors (context); and (5) limited impact of user characteristics on DMHI outcomes (context).</p><p><strong>Conclusions: </strong>There is preliminary evidence that DMHIs can be delivered to people experiencing psychosis within trial settings, although use varied between individuals. Future implementation efforts may benefit from addressing contextual factors influencing DMHI use, including users' treatment needs and preferences, everyday demands, and staff availability for blended interventions. Future research could evaluate implementation strategies, validate how and for whom DMHIs work, and embed process evaluation in trials.</p><p><strong>Trial registration: </strong>PROSPERO CRD42024439117; https://www.crd.york.ac.uk/PROSPERO/view/CRD42024439117.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e88032"},"PeriodicalIF":3.9,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13448200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580263","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":"Multicenter Usability Evaluation and Co-Development of a Digital Decision-Support Tool for Labor Triage: Mixed Methods Study.","authors":"Mariana Tome, Xavier Laurent, Kristiyan Georgiev, John Tolladay, Sarah Collins, Deborah Hedgecott, Lyuba V Bozhilova, Jane E Hirst, Lawrence Impey, Antoniya Georgieva","doi":"10.2196/87589","DOIUrl":"10.2196/87589","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Digital decision-support tools for labor care remain limited, with few technologies successfully addressing the complex, time-sensitive decisions required during labor triage. Fit4Labour is a clinician-facing, data-driven research tool, currently under development, that combines computerized cardiotocography interpretation with maternal and fetal risk factors to generate individualized risk scores at labor onset. Its primary aim is to support clinicians in identifying fetuses who may require closer monitoring or expedited delivery, while simultaneously providing reassurance in low-risk cases. By promoting consistent communication and timely escalation of care, the Fit4Labour tool seeks to strengthen clinical decision-making. Understanding and addressing usability and implementation barriers will be critical to its adoption in clinical practice.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to evaluate whether a digitally co-developed labor decision-support tool (Fit4Labour) maintains usability and implementation readiness across NHS hospitals with differing clinical contexts.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a convergent parallel mixed methods study in 3 United Kingdom hospitals (December 2022 to May 2025). Phase 1 involved iterative co-development with midwives and doctors at Oxford University Hospitals NHS Foundation Trust; Phase 2 validated the locked version at Birmingham Women's and Children's NHS Foundation Trust and Buckinghamshire Healthcare NHS Trust. Participants completed scenario-based usability sessions evaluated with the System Usability Scale (SUS) and Single Ease Question (SEQ), and task completion time, followed by focus groups and interviews analyzed thematically.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Twenty-six health care professionals participated: 12 in co-development (7 midwives, 5 doctors) and 14 in validation (8 midwives, 6 doctors) phases. During co-development at Oxford, the tool met the \"excellent\" usability threshold (mean SUS 82.1, SD 12.3), indicating readiness for the validation phase. The locked version (v4.0) independently met the \"excellent\" threshold at both validation sites (combined mean SUS 85.8, SD 10.2; Birmingham 80.7, SD 10.8; Buckinghamshire 90.8, SD 7.2). Task completion times were comparable across validation sites (Birmingham 10.3, SD 1.6 min; Buckinghamshire 9.2, SD 1.9 min), while SEQ scores were consistently high across all scenarios (mean 6.1/7, SD 0.8). Thematic analysis identified 12 themes within 3 domains: clinical integration and workflow, technology adoption and implementation, and patient safety and decision-making. Participants described the Fit4Labour tool as a supportive tool, \"like a co-pilot,\" improving confidence in decisions with the potential to aid triage assessment. Perceived limitations included an incomplete risk factor profile and the need for minor technical adjustments or integration with existing hospital systems.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conc","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e87589"},"PeriodicalIF":3.9,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13395436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580297","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":"Japanese Health Information Technology Usability Evaluation Scale for Sexually Transmitted Infection-Related Chatbots: Development and Psychometric Validation Study.","authors":"Tomoko Hato, Hirono Ishikawa, Kense Todo, Keisuke Harada, Atsushi Yoshikawa, Yoshiharu Fukuda, Rebecca Schnall","doi":"10.2196/90483","DOIUrl":"10.2196/90483","url":null,"abstract":"<p><strong>Background: </strong>The rapid expansion of mobile technology has accelerated the integration of health applications and conversational AI into clinical and public health practices. To ensure these tools are effective and sustainable, usability evaluations and early user engagement during development are essential. The Health Information Technology Usability Evaluation Scale (Health-ITUES) is a validated and flexible usability assessment instrument that is available in multiple languages and applicable across diverse contexts. However, a Japanese version of this scale has not yet been developed.</p><p><strong>Objective: </strong>This study aimed to translate and validate a Japanese version of the Health-ITUES, customized for a sexually transmitted infection (STI)-related chatbot, and to support the usability assessment of emerging mobile health tools in Japan.</p><p><strong>Methods: </strong>We developed a Japanese version of the Health-ITUES using a chatbot under development as a consultation tool for young women regarding STIs. First, the original scale was customized to reflect the chatbot's specific purpose and intended usage context. Following established translation guidelines, we conducted forward translation from English to Japanese, back translation, expert review, and reconciliation. We then evaluated the reliability and validity of the Japanese version in a sample of 301 young women.</p><p><strong>Results: </strong>The Japanese version of the Health-ITUES demonstrated high internal consistency (Cronbach α=0.85-0.98). Confirmatory factor analysis supported acceptable construct validity (root mean square error of approximation is 0.10, comparative fit index>0.90). Additionally, the Health-ITUES scores showed strong correlations with satisfaction and usage intention for the tool (r=0.779 and 0.797, respectively).</p><p><strong>Conclusions: </strong>The Japanese version of the Health-ITUES provides initial evidence of reliability and validity in an STI-related scenario among young women and may facilitate more rigorous usability evaluations of mHealth and conversational AI tools in Japan.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e90483"},"PeriodicalIF":3.9,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13394856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580255","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":"Validation of the Taiwan Chinese Version of the Assistive Technology Usability Questionnaire for People With Neurological Diseases for Wearable Robotic Exoskeletons: Usability Study.","authors":"Hander Wang, Jian-Jia Huang, Yu-Cheng Pei, Huey-Wen Liang","doi":"10.2196/89556","DOIUrl":"10.2196/89556","url":null,"abstract":"<p><strong>Background: </strong>Assessing usability is important given the increasing use of technology in rehabilitation. While wearable robotic exoskeletons (WREs) are commonly incorporated into neurological rehabilitation in both clinical and community settings, there is a need to examine the applicability of different usability instruments in this context. The Assistive Technology Usability Questionnaire for People with Neurological Diseases (NATU Quest) was developed to evaluate the usability of assistive technology in individuals with neurological conditions. However, its reliability and validity have been established only for assistive devices such as wheelchairs and canes, restricting its generalizability.</p><p><strong>Objective: </strong>This study aimed to cross-culturally adapt a Taiwan Chinese version of the NATU Quest and to preliminarily evaluate its applicability, reliability, and validity for assessing WRE use among patients who had a stroke as an expanding application context.</p><p><strong>Methods: </strong>Cross-cultural adaptation was achieved through a structured translation from Spanish to Taiwan Chinese, followed by content validation by an expert panel of 10 raters. Following the adaptation process, psychometric testing of the NATU Quest was administered to 20 patients who had a stroke following the completion of a comprehensive course of robot-assisted gait training facilitated by a WRE. The internal consistency of the NATU Quest was evaluated using the Cronbach α coefficient. The reliability of the test-retest procedure was evaluated using the intraclass correlation coefficient (ICC). Convergent validity was ascertained by examining the correlation between the NATU Quest scores and the System Usability Scale (SUS).</p><p><strong>Results: </strong>The culturally adapted NATU Quest showed acceptable content validity, with item-level content validity index (CVI) values ranging from 0.80 to 1.00 and scale-level CVI values of 0.93 for clarity and 0.97 for relevance. Cronbach α was 0.943, indicating high internal consistency. Of the 20 participants who completed all 6 rehabilitation sessions, 13 participants completed repeat testing. Preliminary test-retest reliability was acceptable (ICC=0.823; P<.001; SE of measurement=0.31). NATU Quest scores were strongly correlated with SUS scores (Spearman ρ=0.818; P<.001), providing preliminary support for convergent validity.</p><p><strong>Conclusions: </strong>The adapted NATU Quest demonstrated promising preliminary psychometric properties when applied to WRE use among individuals who had a stroke. Further studies with larger sample sizes are warranted to examine additional psychometric properties such as construct validity and responsiveness.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e89556"},"PeriodicalIF":3.9,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13384474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537313","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":"Video-Algorithmic Patient Monitoring in Mental Health Inpatient Settings: Qualitative Study of Patient or Consumer, Clinician, and Vendor Perspectives.","authors":"Piers Gooding, Hamilton Kennedy, Simon D'Alfonso, Timothy Kariotis, Catherine Daniel, Bridget Hamilton","doi":"10.2196/85518","DOIUrl":"10.2196/85518","url":null,"abstract":"<p><strong>Background: </strong>Video-algorithmic patient monitoring (VAPM) combines remote, noncontact sensors and algorithmic analysis and is increasingly trialed in acute psychiatric and other care settings. While promoted for improving safety and reducing risk, it raises ethical concerns regarding safety, privacy and surveillance. Little is known about how those encountering VAPM in mental health care contexts anticipate its use and potential impacts, including where it has not yet been implemented.</p><p><strong>Objective: </strong>This study aimed to explore the views of patients or mental health consumers, specialized mental health nurses and nurse academics, hospital managers, and technology vendors regarding the appropriateness and anticipated implications of VAPM in mental health inpatient care.</p><p><strong>Methods: </strong>This qualitative study identified key stakeholders in Australia via networking techniques for participation in a deliberative workshop. A deliberative workshop was held, and the workshop discussion was audio-recorded, transcribed, and thematically analyzed, consistent with methods in health technology research, which enable exploration of different viewpoints, including convergences and divergences across stakeholder groups.</p><p><strong>Results: </strong>In total, 16 stakeholders participated, exploring themes concerning (1) contestation over the rationale for VAPM in mental health settings, (2) VAPM reshaping care and relationships, (3) perceived harms of VAPM, (4) perceived observational support for safety and reduced disruption, (5) serious privacy implications of VAPM, (6) the need for appropriate governance, and (7) the potential for VAPM to transform, not augment, service delivery. General views differed across groups. Patients or service users expressed concerns about privacy, coercion, and the potential to intensify stigma. Mental health nurses were cautious but interested in possible benefits for safety and suicide prevention. Hospital managers and technology vendors largely emphasized safety gains.</p><p><strong>Conclusions: </strong>The findings suggest that the anticipated risks of VAPM are primarily experienced subjectively, as infringements on privacy, dignity, and trust, while purported benefits remain largely untested and unquantified. From a utilitarian perspective, direct comparison is therefore difficult-the risks are set out in the anticipated experiences of those with lived experience, and the benefits remain hypothetical. From this view, robust, independent evidence of real-world outcomes is required. Yet, for some participants, the very premise of such calculation was rejected, with privacy, dignity, and trust regarded as nonnegotiable, rather than items for trade-off. If VAPM is to be pursued at all, it should proceed only with extreme caution, with transparent evidence of outcomes, and with meaningful participation from those whose lives and care are most directly impacted.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e85518"},"PeriodicalIF":3.9,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13384473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537281","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":"Body Image and Eating Disorder Education Chatbot, JEM, in Australia and Canada: First 6-Month Real-World Survey Evaluation.","authors":"Gemma Sharp, Sara Marini, Emily Tam, Hao Hu","doi":"10.2196/90783","DOIUrl":"10.2196/90783","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Body image dissatisfaction, disordered eating, and eating disorders represent significant public health concerns; however, many affected individuals never access evidence-based support. We co-designed and developed a rule-based chatbot, JEM, which conducts conversations addressing evidence-based psychoeducation and psychotherapeutic microinterventions. We previously demonstrated the feasibility, acceptability, and preliminary satisfaction of the JEM chatbot in a research setting. However, broader satisfaction, experiences, and user-reported outcomes in real-world settings have not yet been investigated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to conduct a real-world evaluation of the JEM chatbot in Australia and Canada, the two countries that have hosted a deployment of the chatbot to date. Specifically, we aim to explore user satisfaction and experiences with the chatbot and within-session differences in user mood and body image satisfaction when completing the chatbot's microinterventions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Respondents were users of the JEM chatbot aged 13 to 64 years who self-selected to complete a web-based overall evaluation survey (N=230; n=122 in Australia and n=108 in Canada) over a 6-month period. This evaluation survey included user demographic characteristics, satisfaction measures, and the System Usability Scale. Respondents for the within-session pre-post analyses were JEM chatbot users who chose to complete brief web-based surveys immediately before and after completing one of the chatbot's microinterventions during the same 6-month period. Sample sizes varied across microinterventions, ranging from 75 to 276 respondents overall (Australia: n=34-146; Canada: n=39-130). These surveys included validated visual analog scales (VAS) measuring mood (anxiety, depression, happiness, confidence) and body image satisfaction (body size satisfaction, body shape satisfaction, physical attractiveness).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Demographic characteristics showed that survey respondents were commonly young adult cisgender women and nonbinary individuals across Australia and Canada. Respondent satisfaction with the chatbot was high in both countries (Australia: mean 76.1, SD 22.7; Canada: mean 78.8, SD 14.3), and the usability of the chatbot was rated as \"excellent\" in both countries (Australia: mean 86.5, SD 16.9; Canada: mean 89.5, SD 11.6) according to the System Usability Scale. Across completed microintervention surveys, patterns of within-session pre-post ratings were broadly similar in Australia and Canada, with effect sizes generally ranging from very small to large across VAS-measured mood and body image outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The JEM chatbot achieved high satisfaction and usability ratings. Among respondents who completed pre-post surveys, immediate within-session differences in mood and body image ratings were observed following the completion of chatbot","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e90783"},"PeriodicalIF":3.9,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13384424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537231","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}