PLOS digital healthPub Date : 2025-04-24eCollection Date: 2025-04-01DOI: 10.1371/journal.pdig.0000844
Samantha A Svärdh, Giana Carli Lorenzini, Ulli Samuelsson, Steven M Schmidt, Susanne Iwarsson, Sofi Fristedt
{"title":"\"It is very convenient when it works - successes and challenges with welfare technology\" - a qualitative study.","authors":"Samantha A Svärdh, Giana Carli Lorenzini, Ulli Samuelsson, Steven M Schmidt, Susanne Iwarsson, Sofi Fristedt","doi":"10.1371/journal.pdig.0000844","DOIUrl":"https://doi.org/10.1371/journal.pdig.0000844","url":null,"abstract":"<p><p>Welfare technology (WT) use is increasingly advocated to facilitate aging in place. However, it remains unclear how older adults and homecare staff perceive these digital technologies in practice. This qualitative study investigated the ways in which current WT either facilitated or fell short in supporting older adults in their daily lives and homecare staff at work. Four key themes were developed using thematic analysis: 1) Successes and challenges with ease of use (i.e., how simple it is to interact with the WT); 2) Successes and challenges with usefulness (i.e., how effective the WT is in achieving its intended purpose); 3) Challenges with appearance, sounds and physical location; and 4) Challenges with technical maintenance and vulnerabilities. Findings revealed paradoxes in both older adult and homecare staff user perceptions. For instance, some successes with WT's usefulness were highlighted, like GPS safety alarms in supporting older adult independence. However, challenges in usefulness were also exposed, like staff hiding \"overused\" safety alarms. Except for the medication robot, none of the WT devices clearly alleviated anticipated homecare staff shortages. WT perceived as auditorily or visually inadequate, that required more effort than users could comfortably manage, or that organizations could seamlessly integrate, were generally regarded as challenging. To overcome such challenges, greater involvement from older adults and homecare staff in the design and implementation of WT within homecare contexts is necessary. Refined criteria for prescribing WT to individuals, particularly regarding cognitive status, are additionally recommended by the researchers.</p>","PeriodicalId":74465,"journal":{"name":"PLOS digital health","volume":"4 4","pages":"e0000844"},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12021168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060650","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}
PLOS digital healthPub Date : 2025-04-23eCollection Date: 2025-04-01DOI: 10.1371/journal.pdig.0000814
Daniel Ishoso, Eric Mafuta, Kourtney Bettinger, Carl Bose, Benjamin H Chi, Ingunn Haug, Patricia Gomez, Joar Eilevstjønn, Abigail McRea, Helge Myklebust, Antoinette Tshefu, Jackie K Patterson
{"title":"Preclinical usability evaluation of the Liveborn app: A mobile health application that provides feedback for neonatal resuscitation.","authors":"Daniel Ishoso, Eric Mafuta, Kourtney Bettinger, Carl Bose, Benjamin H Chi, Ingunn Haug, Patricia Gomez, Joar Eilevstjønn, Abigail McRea, Helge Myklebust, Antoinette Tshefu, Jackie K Patterson","doi":"10.1371/journal.pdig.0000814","DOIUrl":"https://doi.org/10.1371/journal.pdig.0000814","url":null,"abstract":"<p><p>Neonatal mortality, particularly due to failure to breathe at birth, remains a significant challenge in low- and middle-income countries (LMICs). Effective neonatal resuscitation is essential to improving survival, but is challenging to implement consistently at the bedside. The Liveborn mobile health application for newborn resuscitation was developed to provide real-time guidance and support debriefing for healthcare workers in LMICs. Liveborn allows an observer to document the timing of key actions during a resuscitation; it then compares the observer data to recommended care and provides data-driven feedback. This study aimed to evaluate the usability of Liveborn in simulated resuscitations. We conducted two rounds of simulated resuscitations using Liveborn with midwives at one health facility in the Democratic Republic of Congo. Each round included ten simulations, with half testing real-time guidance and half focusing on debriefing. Between rounds, Liveborn was iteratively refined based on analysis of video-recordings of the simulations and participant surveys. Midwives' perceptions of usability and feasibility were assessed using previously validated survey tools including the System Usability Scale (SUS) with a score >68 considered above average, and the Feasibility of Intervention Measure (FIM) with a score >12 considered above neutral. Round 1 of testing identified several key usability issues including difficulty accurately recording events, poor adherence to audio guidance that was insufficiently specific, and poor flow of debriefing for intrapartum stillbirth cases. The Liveborn app, after iterative refinement, demonstrated excellent usability (median SUS score of 90 [Q1, Q3: 85, 95]) and excellent feasibility (median FIM score of 19 [16, 20]). Further research is needed to assess Liveborn's effectiveness in real clinical settings and its impact on neonatal outcomes in LMICs.</p>","PeriodicalId":74465,"journal":{"name":"PLOS digital health","volume":"4 4","pages":"e0000814"},"PeriodicalIF":0.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12017530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993964","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}
PLOS digital healthPub Date : 2025-04-23eCollection Date: 2025-04-01DOI: 10.1371/journal.pdig.0000684
Alessandra Diana Gentile, Yosua Yan Kristian, Erica Cini
{"title":"Effectiveness of unguided internet-based computer self-help platforms for eating disorders (with or without an associated app): A systematic review.","authors":"Alessandra Diana Gentile, Yosua Yan Kristian, Erica Cini","doi":"10.1371/journal.pdig.0000684","DOIUrl":"10.1371/journal.pdig.0000684","url":null,"abstract":"<p><strong>Background: </strong>Following the COVID-19 pandemic, internet-based computer self-help platforms for eating disorders (EDs) became increasingly prevalent as a tool to effectively prevent and treat ED symptoms and related behaviours. This systematic review explored the effectiveness of unguided internet-based computer self-help platforms for EDs.</p><p><strong>Methods: </strong>From inception to the 31st of May 2024, a systematic search of Ovid MEDLINE, Embase, Global Health, and APA PsycInfo was conducted. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Outcome quality assessments were conducted according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE).</p><p><strong>Results: </strong>12 RCTs, with a total of 3400 participants, were included. 2 studies explored the effectiveness as primary prevention, 7 as secondary prevention, and 3 as tertiary intervention. The gathered literature demonstrated unguided internet-based computer self-help platforms as effective in reducing ED core symptoms and related behaviours, with psychoeducation, cognitive behavioural, and dissonance-based approaches being the most prevalent approaches.</p><p><strong>Conclusions: </strong>Unguided internet-based computer self-help platforms are effective in the short-term reduction of ED symptoms and associated behaviours and should be implemented in the early stages of a tiered healthcare system for ED treatments.</p><p><strong>Trial registration: </strong>Prospero (CRD42024520866).</p>","PeriodicalId":74465,"journal":{"name":"PLOS digital health","volume":"4 4","pages":"e0000684"},"PeriodicalIF":0.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12017517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054976","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":"Factors motivating maternal healthcare clients to use mHealth interventions in rural Malawi.","authors":"Priscilla Maliwichi, Wallace Chigona, Address Malata","doi":"10.1371/journal.pdig.0000805","DOIUrl":"https://doi.org/10.1371/journal.pdig.0000805","url":null,"abstract":"<p><p>Client-facing mHealth interventions have the potential to address the inequalities in accessing health information. In maternal healthcare, mHealth interventions provide information to pregnant women on how they can stay healthy during pregnancy, as well as on the danger signs in pregnancy that can contribute to maternal mortality. This study investigated why maternal healthcare clients are motivated to use mHealth interventions. Data was collected using secondary data sources and semi-structured interviews with maternal clients who used Chipatala Cha Pa Foni mHealth intervention. The study found that access to and attitudes towards technology motivated maternal healthcare clients to use the mHealth intervention. Furthermore, women in rural areas were motivated to use mHealth interventions when the technology suppresses social-cultural norms, technology is designed with affordance potency in mind, women have trust in the source of information, and when communities practice the culture of sharing. These findings have the potential to broaden the understanding of what and why beneficiaries of digital health might be motivated to use digital technologies in poor-resource settings.</p>","PeriodicalId":74465,"journal":{"name":"PLOS digital health","volume":"4 4","pages":"e0000805"},"PeriodicalIF":0.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058000","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}
PLOS digital healthPub Date : 2025-04-22eCollection Date: 2025-04-01DOI: 10.1371/journal.pdig.0000809
Octavio Diaz-Hernandez
{"title":"A worldwide research overview of Artificial Proprioception in prosthetics.","authors":"Octavio Diaz-Hernandez","doi":"10.1371/journal.pdig.0000809","DOIUrl":"https://doi.org/10.1371/journal.pdig.0000809","url":null,"abstract":"<p><p>Proprioception is the body's ability to sense its position and movement, which is essential for motor control. Its loss after amputation poses significant challenges for prosthesis users. Artificial Proprioception enhances sensory feedback and motor control in prosthetic devices. This review provides a global overview of current research and technology in the field, emphasizing feedback mechanisms, neural interfaces, and biomechatronic integration. This work examines innovations in sensory feedback for amputees, including electrotactile and vibrotactile stimulation, artificial intelligence, and neural interfaces to enhance prosthetic control. The methodology involved reviewing studies from Scopus, Web of Science, and PubMed on prosthetic proprioceptive feedback from 2004 to 2024, evaluating sensory feedback research by author, country, and affiliation with a synthesis provided. Countries like the United States and Italy are collaborating to advance global research. The paper concludes with potential developments, such as advanced, user-centered prosthetics that meet amputees' sensory needs and significantly enhance their quality of life.</p>","PeriodicalId":74465,"journal":{"name":"PLOS digital health","volume":"4 4","pages":"e0000809"},"PeriodicalIF":0.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The effects of an app to prevent negative outcomes of cyberbullying: A cluster randomized controlled trial.","authors":"Helene Høgsdal, Sabine Kaiser, Geraldine Mabille, Kyrre Breivik, Frode Adolfsen, Monica Martinussen, Henriette Kyrrestad","doi":"10.1371/journal.pdig.0000819","DOIUrl":"https://doi.org/10.1371/journal.pdig.0000819","url":null,"abstract":"<p><p>Experiencing cyberbullying and negative incidents online can negatively affect adolescents' mental health and well-being. NettOpp is a mobile application aiming to reduce the harmful effects of cyberbullying and negative incidents online on mental health outcomes. To evaluate the effect of the mobile app, a cluster randomized controlled trial design with three measurement points was conducted. Thirty-two Norwegian primary and secondary schools were randomly assigned to either an intervention group where the pupils (n = 259) got access to NettOpp during the study period, or to a waiting-list control group where the pupils (n = 327) got access to NettOpp after the study period. No significant findings were found in the intention-to-treat analyses, but the results from per-protocol analyses showed a decrease in hyperactivity problems among the adolescents that had used the app (F(4,1585) = 2.89, p =.021). Users of the app reported being more exposed to negative incidents online during the study period (F(2,1591) = 3.94, p =.020). The frequency of cyberbullying decreased during the study period, but among all study participants, including those who had not used the app. The findings provide valuable insight into whether mobile apps can function as preventive and supportive self-help resources in reducing the harmful effects of cyberbullying and negative online incidents on mental health outcomes among adolescents.</p>","PeriodicalId":74465,"journal":{"name":"PLOS digital health","volume":"4 4","pages":"e0000819"},"PeriodicalIF":0.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030428","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":"Intention to use mobile health in antenatal care service: Among primary health care unit workers, Bench-Sheko zone, southwest Ethiopia.","authors":"Shimeles Wondimu, Mohamed J Abawari, Yohannes Kebede","doi":"10.1371/journal.pdig.0000587","DOIUrl":"https://doi.org/10.1371/journal.pdig.0000587","url":null,"abstract":"<p><p>The use of mobile health (mHealth) technology has the potential to enhance maternal and child health care, particularly in low-income countries. However, evidence regarding its practicality and effectiveness remains limited. In Ethiopia, research on health workers' intention to adopt mHealth technology for maternal health services is notably scarce, emphasizing the need for thoughtful evaluation and further studies to explore its real-world application. This study aims to assess the intention of primary health care unit workers towards using mobile health technology in antenatal care services in Bench-Sheko Zone, Southwest Ethiopia. A cross-sectional study was conducted from June 27, 2023, to July 27, 2023. Data were collected from 316 primary health care unit workers using a simple random sampling technique. SPSS version 25 was used for data analysis, including multivariable linear regression modeling. The response rate was 98.7%. The mean age of participants was 29.2 years, and the mean score for behavioral intention to use mobile technology in ANC services was 65%. Predictors included perceived mobile self-efficacy (β=0.318, p<0.001), perceived compatibility (β=0.601, p<0.001), mobile ownership (β=1.173, p=0.041), eHealth training (β=0.768, p=0.008), and mobile use experience (β=0.176, p<0.001). Local health managers should facilitate training to boost health workers' mobile self-efficacy, and policymakers should consider the compatibility of mHealth technology with existing practices.</p>","PeriodicalId":74465,"journal":{"name":"PLOS digital health","volume":"4 4","pages":"e0000587"},"PeriodicalIF":0.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055075","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}
PLOS digital healthPub Date : 2025-04-21eCollection Date: 2025-04-01DOI: 10.1371/journal.pdig.0000826
Austin M Stroud, Sarah A Minteer, Xuan Zhu, Jennifer L Ridgeway, Jennifer E Miller, Barbara A Barry
{"title":"Patient information needs for transparent and trustworthy cardiovascular artificial intelligence: A qualitative study.","authors":"Austin M Stroud, Sarah A Minteer, Xuan Zhu, Jennifer L Ridgeway, Jennifer E Miller, Barbara A Barry","doi":"10.1371/journal.pdig.0000826","DOIUrl":"https://doi.org/10.1371/journal.pdig.0000826","url":null,"abstract":"<p><p>As health systems incorporate artificial intelligence (AI) into various aspects of patient care, there is growing interest in understanding how to ensure transparent and trustworthy implementation. However, little attention has been given to what information patients need about these technologies to promote transparency of their use. We conducted three asynchronous online focus groups with 42 patients across the United States discussing perspectives on their information needs for trust and uptake of AI, focusing on its use in cardiovascular care. Data were analyzed using a rapid content analysis approach. Our results suggest that patients have a set of core information needs, including specific information factors pertaining to the AI tool, oversight, and healthcare experience, that are relevant to calibrating trust as well as perspectives concerning information delivery, disclosure, consent, and physician AI use. Identifying patient information needs is a critical starting point for calibrating trust in healthcare AI systems and designing strategies for information delivery. These findings highlight the importance of patient-centered engagement when developing AI model documentation and communicating and provisioning information about these technologies in clinical encounters.</p>","PeriodicalId":74465,"journal":{"name":"PLOS digital health","volume":"4 4","pages":"e0000826"},"PeriodicalIF":0.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12011294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047814","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}
PLOS digital healthPub Date : 2025-04-21eCollection Date: 2025-04-01DOI: 10.1371/journal.pdig.0000808
Alana R Lopez, Elizabeth Haight, Linda Guijosa, Briana Williams, Jennifer Unger, Luz Messina, Mina Halpern, Samantha Stonbraker, Keshet Ronen
{"title":"Experiences of social support and the role of engagement in a digital educational support group for adolescent mothers' health in the Dominican Republic.","authors":"Alana R Lopez, Elizabeth Haight, Linda Guijosa, Briana Williams, Jennifer Unger, Luz Messina, Mina Halpern, Samantha Stonbraker, Keshet Ronen","doi":"10.1371/journal.pdig.0000808","DOIUrl":"https://doi.org/10.1371/journal.pdig.0000808","url":null,"abstract":"<p><p>In 2021, nearly 66 of every 1,000 adolescent girls ages 15-19 in the Dominican Republic gave birth. Adolescent mothers face health disparities including increased risk for rapid repeat pregnancy and lower breastfeeding rates. Mobile health (mHealth) is a growing approach for reaching adolescents. FAMA (Fortaleciendo la Autodeterminación de Madres Adolescentes) was a 12-week moderated digital education support group with adolescent mothers in the Dominican Republic, associated with improvements in health knowledge and contraceptive uptake. This study explores the FAMA intervention's mechanism of action through a mixed-methods secondary data analysis using WhatsApp messages and post-intervention interviews to characterize experiences of social support and patterns of intervention engagement. We assessed associations between multiple measures of engagement and intervention outcomes. Linear or Poisson regression was used to evaluate association with health knowledge, and social support. or contraceptive uptake, respectively, selected based on type and distribution of each outcome variable. Models adjusted for key confounders. Findings indicate FAMA was largely used to exchange companionship and informational support. We found a significant positive association between engagement as measured by acknowledging intervention messages and improved health knowledge (adjusted coefficient: 2.84, CI: 0.83-4.84, p= 0.01). In contrast, we found a negative association between engagement as measured by social support exchange and improved health knowledge (adjusted coefficient: -5.78, CI: -10.42- -1.00, p= 0.02), suggesting that interactions focused on support may not reinforce informational content as directly as other forms of engagement. Our findings suggest that engagement with FAMA was associated with increases in knowledge and a close reading of message content is most beneficial for knowledge gain. This analysis enhances understanding of user engagement with group mHealth interventions and contributes new approaches to measure engagement, accounting for different engagement styles participants may have. Future digital interventions may leverage our findings to design interventions that encourage beneficial engagement types.</p>","PeriodicalId":74465,"journal":{"name":"PLOS digital health","volume":"4 4","pages":"e0000808"},"PeriodicalIF":0.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12011247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014681","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}