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Outcomes of a Comprehensive Mobile Vaping Cessation Program in Adults Who Vape Daily: Cohort Study. 针对每天吸食大麻的成年人的综合移动戒烟计划的成果:队列研究。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-28 DOI: 10.2196/57376
Jennifer D Marler, Craig A Fujii, MacKenzie T Utley, Daniel J Balbierz, Joseph A Galanko, David S Utley
<p><strong>Background: </strong>In the United States, e-cigarettes, or vapes, are the second most commonly used tobacco product. Despite abundant smartphone app-based cigarette cessation programs, there are few such programs for vaping and even fewer supporting data.</p><p><strong>Objective: </strong>This exploratory, prospective, single-arm, remote cohort study of the Pivot vaping cessation program assessed enrollment and questionnaire completion rates, participant engagement and retention, changes in attitudes toward quitting vaping, changes in vaping behavior, and participant feedback. We aimed to establish early data to inform program improvements and future study design.</p><p><strong>Methods: </strong>American adults aged ≥21 years who vaped daily, reported ≥5 vape sessions per day, and planned to quit vaping within 6 months were recruited on the web. Data were self-reported via app- and web-based questionnaires. Outcomes included engagement and retention (ie, weeks in the program, number of Pivot app openings, and number of messages sent to the coach), vaping attitudes (ie, success in quitting and difficulty staying quit), vaping behavior (ie, quit attempts, Penn State Electronic Cigarette Dependence Index, 7- and 30-day point-prevalence abstinence [PPA], and continuous abstinence [defined as ≥7-day PPA at 12 weeks+30-day PPA at 26 weeks+0 vaping sessions since 12 weeks]), and participant feedback.</p><p><strong>Results: </strong>In total, 73 participants onboarded (intention-to-treat sample); 68 (93%) completed the 12- and 26-week questionnaires (completer samples). On average, participants were active in Pivot for 13.8 (SD 7.3) weeks, had 87.3 (SD 99.9) app sessions, and sent 37.6 (SD 42.3) messages to their coach over 26 weeks. Mean success in quitting and difficulty staying quit (scale of 1-10) improved from baseline to 12 weeks-4.9 (SD 2.9) to 7.0 (SD 3.0) and 4.0 (SD 2.8) to 6.2 (SD 3.1), respectively (P<.001 in both cases). Most participants (64/73, 88%) made ≥1 quit attempt. At 26 weeks, intention-to-treat 7-day PPA, 30-day PPA, and continuous abstinence rates were 48% (35/73), 45% (33/73), and 30% (22/73), respectively. In total, 45% (33/73) of the participants did not achieve 7-day PPA at 26 weeks; their mean Penn State Electronic Cigarette Dependence Index score decreased from baseline (13.9, SD 3.1) to 26 weeks (10.8, SD 4.5; mean change -3.2, SD 3.9; P<.001); 48% (16/33) of these participants improved in the e-cigarette dependence category. At 2 weeks, 72% (51/71) of respondents reported that using Pivot increased their motivation to quit vaping; at 4 weeks, 79% (55/70) reported using Pivot decreased the amount they vaped per day.</p><p><strong>Conclusions: </strong>In this first evaluation of Pivot in adult daily vapers, questionnaire completion rates were >90%, average program engagement duration was approximately 14 weeks, and most participants reported increased motivation to quit vaping. These and early cessation outcomes
背景:在美国,电子烟或吸食器是第二大最常用的烟草产品。尽管有大量基于智能手机应用程序的戒烟计划,但针对吸食电子烟的此类计划却很少,支持数据更是少之又少:这项探索性、前瞻性、开放标签、单臂、远程、初步队列研究评估了 Pivot 吸烟戒烟计划的注册率和问卷完成率、参与者的参与度和保持率、对戒烟态度的改变、吸烟行为的改变以及参与者的反馈。目的是在上述各方面建立早期数据,为项目改进和未来研究设计提供依据:方法:在线招募年龄≥ 21 岁、每天吸食、每天吸食次数≥ 5 次且计划在未来 6 个月内戒烟的美国成年人。在开始使用 Pivot 之前,参与者要完成在线筛选表、筛选电话、电子知情同意书、注册和入职培训。数据通过应用程序和网络问卷进行自我报告。结果主要集中在参与度和保持率(即参与计划的周数、打开 Pivot 应用程序的次数、向教练发送信息的次数);吸烟态度(即戒烟成功率、保持戒烟的难度);吸烟行为(即戒烟尝试、宾夕法尼亚州立大学电子烟戒烟率)、戒烟尝试、宾夕法尼亚州立大学电子烟依赖指数、7 天和 30 天的戒烟点[PPA]、持续戒烟[定义为 12 周内≥ 7 天的 PPA + 26 周内 30 天的 PPA + 12 周以来没有吸食过电子烟]];以及参与者反馈:73名参与者完成了入职培训(意向治疗[ITT]样本);68/73(93%)人完成了12周和26周的问卷调查(完成者样本)。平均而言,参与者在 Pivot 上活跃了 13.8 周(标准差为 7.3 周),使用了 87.3 次(标准差为 99.9 次)应用程序,并在 26 周内向教练发送了 37.6 条(标准差为 42.3 条)信息。从基线到 12 周,戒烟成功率和持续戒烟难度(1-10 分)均有所提高:成功戒烟率从 4.9 (SD 2.9) 提高到 7.0 (SD 3.0),持续戒烟率从 4.0 (SD 2.8) 提高到 6.2 (SD 3.1);P 均小于 0.001。大多数参与者(64/73,88%)尝试戒烟≥1次。26 周时,ITT 7 天 PPA、30 天 PPA 和持续戒烟率分别为分别为 35/73(48%)、33/73(45%)和 22/73(30%)。有 33 名参与者在 26 周时未达到 7 天 PPA;他们的宾州电子烟依赖指数平均得分从基线(13.9,SD 3.1)下降到 26 周(10.8,SD 4.5)(平均变化-3.2,SD 3.9,P < .001);近一半(16/33,48%)的电子烟依赖类别有所改善。2周后,51/71人(72%)表示使用Pivot提高了他们戒烟的积极性;4周后,55/70人(79%)表示使用Pivot减少了他们每天的吸烟量:在对成人日常吸食者使用 Pivot 的首次评估中,问卷完成率大于 90%,参与计划的平均时间约为 14 周,大多数参与者表示戒烟的积极性有所提高。这些结果和早期戒烟结果表明,Pivot 可在戒烟中发挥作用,并将为今后的相关研究和计划改进提供信息:临床试验:ClinicalTrials.gov NCT05642598;https://clinicaltrials.gov/study/NCT05642598。
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引用次数: 0
Cocreation of a Video Feedback Tool for Managing Self-Care at Home With Pairs of Older Adults: Remote Experience-Based Co-Design Study. 共同创造一种视频反馈工具,用于管理结对老年人的居家自理:基于经验的远程协同设计研究。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-28 DOI: 10.2196/57219
Susanna Strandberg, Mirjam Ekstedt, Cecilia Fagerström, Sofia Backåberg

Background: Involving older adults in co-design processes is essential in developing digital technologies and health care solutions to enhance self-care management at home, especially for older adults with chronic illness and their companions. Remote co-design approaches could provide technologically sustainable solutions that address their personal needs.

Objective: This study aimed to cocreate and test the usability of a video feedback tool to facilitate self-care management at home.

Methods: This experience-based co-design approach involved collaboration between 4 pairs of older adults, 4 researchers, and 2 service designers in three steps: (1) six iterative workshops (5 remote and 1 in person) to cocreate self-care exercises within an existing video feedback tool by identifying factors influencing self-care management; (2) developing and refining the self-care exercises based on suggestions from the older adults; and (3) usability testing of the cocreated exercises with the 4 pairs of older adults in their homes. Among the older adults (68-78 years), 3 adults had heart failure and 1 adult had hypertension. Data were analyzed inductively through thematic analysis and deductively using the USABILITY (Use of Technology to Engage in Adaptation by Older Adults and/or Those With Low or Limited Literacy) framework.

Results: The identified influencing factors guiding the contents and format development of 2 new self-care exercises were that pairs of older adults support and learn from each other in performing self-care, which increases their motivation and engagement in practicing self-care at home. The usability test of the 2 new self-care exercises, "Breathing exercises" and "Picking up from the floor," revealed that the pairs found the exercises and the video feedback component valuable for learning and understanding, for example, by comparison of performances highlighting movement variability. However, they found it difficult to manage the video feedback tool on their own, and a support structure or tailored education or training was requested.

Conclusions: This study emphasizes that the video feedback tool holds the potential to facilitate learning and understanding in self-care management, which may support motivation. The studied video feedback tool can be beneficial for pairs of older adults managing self-care at home as a complement to traditional health care services, but an accurate supporting structure is required. The effectiveness of the video feedback tool and its integration into existing health care services still need to be assessed and improved through careful design and structured support.

背景:让老年人参与到共同设计过程中,对于开发数字技术和医疗保健解决方案以加强居家自我护理管理至关重要,尤其是对于患有慢性疾病的老年人及其陪伴者而言。远程共同设计方法可以提供技术上可持续的解决方案,满足他们的个人需求:本研究旨在共同设计和测试视频反馈工具的可用性,以促进居家自我护理管理:这种基于经验的共同设计方法涉及 4 对老年人、4 名研究人员和 2 名服务设计师在三个步骤中的合作:(1)6 次迭代研讨会(5 次远程研讨会和 1 次面对面研讨会),通过确定影响自我护理管理的因素,在现有视频反馈工具中共同创建自我护理练习;(2)根据老年人的建议开发和完善自我护理练习;(3)在 4 对老年人家中对共同创建的练习进行可用性测试。在这些老年人(68-78 岁)中,3 人患有心力衰竭,1 人患有高血压。我们通过主题分析对数据进行了归纳分析,并使用 USABILITY(老年人和/或识字率低或识字有限者使用技术参与适应)框架对数据进行了演绎分析:结果发现,指导 2 个新的自我护理练习的内容和形式开发的影响因素是,结对的老年人在进行自我护理时相互支持和学习,从而提高了他们在家中进行自我护理的积极性和参与度。对 "呼吸练习 "和 "从地上拾起 "这两个新的自我保健练习进行的可用性测试表明,这对老年人认为练习和视频反馈部分对于学习和理解很有价值,例如,通过比较表演突出了动作的可变性。然而,他们发现自己很难独立管理视频反馈工具,因此要求提供支持结构或有针对性的教育或培训:本研究强调,视频反馈工具具有促进学习和理解自我护理管理的潜力,这可能有助于激发学习动机。所研究的视频反馈工具可作为传统医疗保健服务的补充,对老年人在家中进行自我护理有帮助,但需要一个准确的支持结构。视频反馈工具的有效性及其与现有医疗保健服务的整合仍有待评估,并通过精心设计和结构化支持加以改进。
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引用次数: 0
Client Perspectives of Case Stories in Internet-Delivered Cognitive Behavioral Therapy for Public Safety Personnel: Mixed Methods Study. 针对公共安全人员的互联网认知行为疗法中案例故事的客户视角:混合方法研究。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-25 DOI: 10.2196/64454
Jill Ab Price, Julia Gregory, Hugh C McCall, Caeleigh A Landry, Janine D Beahm, Heather D Hadjistavropoulos

Background: Internet-delivered cognitive behavioral therapy (ICBT) is an effective and convenient means of offering cognitive behavioral therapy to the general population. To increase access to ICBT among Canadian public safety personnel (PSP)-a group that experiences elevated rates of mental health concerns and barriers to mental health care-a clinical research unit called PSPNET has tailored ICBT to PSP, primarily through offering case stories and PSP-specific examples within an ICBT program. PSPNET's first and most frequently used ICBT program, called the PSP Wellbeing Course, has been found to reduce symptoms of mental disorders (eg, anxiety, depression, and posttraumatic stress) among PSP. Little research, however, has investigated clients' perceptions of the case stories in this course.

Objective: This study was designed to expand the literature on the use and evaluation of case stories in ICBT among PSP. Specifically, this study investigated (1) PSP's perceptions of the case stories using the theoretical model provided by Shaffer and Zikmund-Fisher and (2) PSP feedback on the case stories in the PSP Wellbeing Course.

Methods: This study included 41 clients who completed the PSP Wellbeing Course. Of these, 27 clients completed a bespoke questionnaire called the Stories Questionnaire, 10 of whom also participated in a semistructured interview.

Results: Findings show that perceptions of the case stories in the PSP Wellbeing Course were largely positive and that the case stories were generally successful in achieving the 5 purposes of case stories (ie, informing, comforting, modeling, engaging, and persuading) proposed by Shaffer and Zikmund-Fisher. Client feedback also identified 3 tangible areas for story improvement: characters, content, and delivery. Each area highlights the need for and potential benefits of story development. Not all PSP engaged with the case stories, though, so results must be interpreted with caution.

Conclusions: Overall, this study adds to the growing body of research supporting the use of case stories in internet-delivered interventions among PSP.

Trial registration: ClinicalTrials.gov NCT04127032; https://www.clinicaltrials.gov/ct2/show/NCT04127032.

背景介绍互联网认知行为疗法(ICBT)是向普通人群提供认知行为疗法的一种有效而便捷的方法。加拿大公共安全人员(PSP)是一个心理健康问题和心理保健障碍发生率较高的群体,为了让更多的加拿大公共安全人员接受认知行为疗法,一个名为 PSPNET 的临床研究机构为加拿大公共安全人员量身定制了认知行为疗法,主要是通过在认知行为疗法项目中提供案例故事和针对加拿大公共安全人员的实例。PSPNET 的第一个也是最常用的 ICBT 项目名为 "PSP 健康课程"(PSP Wellbeing Course),已被证实可以减轻 PSP 的精神障碍症状(如焦虑、抑郁和创伤后应激)。然而,很少有研究调查客户对该课程中案例故事的看法:本研究旨在扩展有关在 PSP 的 ICBT 中使用和评估案例故事的文献。具体来说,本研究调查了(1)PSP 使用 Shaffer 和 Zikmund-Fisher 提供的理论模型对案例故事的看法;(2)PSP 对 PSP 健康课程中案例故事的反馈:本研究包括 41 名完成 PSP 健康课程的客户。其中,27 名客户填写了一份名为 "故事问卷 "的定制问卷,其中 10 人还参加了一次半结构化访谈:研究结果表明,人们对 PSP 健康课程中的案例故事的看法大多是积极的,案例故事总体上成功地实现了沙弗和齐蒙德-费舍尔提出的案例故事的 5 个目的(即告知、安慰、示范、吸引和说服)。客户反馈还指出了需要改进的 3 个具体方面:人物、内容和表达方式。每个方面都突出了故事开发的必要性和潜在益处。不过,并非所有 PSP 都参与了案例故事,因此在解释结果时必须谨慎:总体而言,这项研究为越来越多的研究提供了支持,这些研究支持在通过互联网对 PSP 进行干预时使用案例故事:ClinicalTrials.gov NCT04127032; https://www.clinicaltrials.gov/ct2/show/NCT04127032.
{"title":"Client Perspectives of Case Stories in Internet-Delivered Cognitive Behavioral Therapy for Public Safety Personnel: Mixed Methods Study.","authors":"Jill Ab Price, Julia Gregory, Hugh C McCall, Caeleigh A Landry, Janine D Beahm, Heather D Hadjistavropoulos","doi":"10.2196/64454","DOIUrl":"10.2196/64454","url":null,"abstract":"<p><strong>Background: </strong>Internet-delivered cognitive behavioral therapy (ICBT) is an effective and convenient means of offering cognitive behavioral therapy to the general population. To increase access to ICBT among Canadian public safety personnel (PSP)-a group that experiences elevated rates of mental health concerns and barriers to mental health care-a clinical research unit called PSPNET has tailored ICBT to PSP, primarily through offering case stories and PSP-specific examples within an ICBT program. PSPNET's first and most frequently used ICBT program, called the PSP Wellbeing Course, has been found to reduce symptoms of mental disorders (eg, anxiety, depression, and posttraumatic stress) among PSP. Little research, however, has investigated clients' perceptions of the case stories in this course.</p><p><strong>Objective: </strong>This study was designed to expand the literature on the use and evaluation of case stories in ICBT among PSP. Specifically, this study investigated (1) PSP's perceptions of the case stories using the theoretical model provided by Shaffer and Zikmund-Fisher and (2) PSP feedback on the case stories in the PSP Wellbeing Course.</p><p><strong>Methods: </strong>This study included 41 clients who completed the PSP Wellbeing Course. Of these, 27 clients completed a bespoke questionnaire called the Stories Questionnaire, 10 of whom also participated in a semistructured interview.</p><p><strong>Results: </strong>Findings show that perceptions of the case stories in the PSP Wellbeing Course were largely positive and that the case stories were generally successful in achieving the 5 purposes of case stories (ie, informing, comforting, modeling, engaging, and persuading) proposed by Shaffer and Zikmund-Fisher. Client feedback also identified 3 tangible areas for story improvement: characters, content, and delivery. Each area highlights the need for and potential benefits of story development. Not all PSP engaged with the case stories, though, so results must be interpreted with caution.</p><p><strong>Conclusions: </strong>Overall, this study adds to the growing body of research supporting the use of case stories in internet-delivered interventions among PSP.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT04127032; https://www.clinicaltrials.gov/ct2/show/NCT04127032.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"8 ","pages":"e64454"},"PeriodicalIF":2.0,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500823","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}
引用次数: 0
Role of Synchronous, Moderated, and Anonymous Peer Support Chats on Reducing Momentary Loneliness in Older Adults: Retrospective Observational Study. 同步、调节和匿名同伴互助聊天对减少老年人瞬间孤独感的作用:回顾性观察研究
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-25 DOI: 10.2196/59501
Zara Dana, Harpreet Nagra, Kimberly Kilby

Background: Older adults have a high rate of loneliness, which contributes to increased psychosocial risk, medical morbidity, and mortality. Digital emotional support interventions provide a convenient and rapid avenue for additional support. Digital peer support interventions for emotional struggles contrast the usual provider-based clinical care models because they offer more accessible, direct support for empowerment, highlighting the users' autonomy, competence, and relatedness.

Objective: This study aims to examine a novel anonymous and synchronous peer-to-peer digital chat service facilitated by trained human moderators. The experience of a cohort of 699 adults aged ≥65 years was analyzed to determine (1) if participation, alone, led to measurable aggregate change in momentary loneliness and optimism and (2) the impact of peers on momentary loneliness and optimism.

Methods: Participants were each prompted with a single question: "What's your struggle?" Using a proprietary artificial intelligence model, the free-text response automatched the respondent based on their self-expressed emotional struggle to peers and a chat moderator. Exchanged messages were analyzed to quantitatively measure the change in momentary loneliness and optimism using a third-party, public, natural language processing model (GPT-4 [OpenAI]). The sentiment change analysis was initially performed at the individual level and then averaged across all users with similar emotion types to produce a statistically significant (P<.05) collective trend per emotion. To evaluate the peer impact on momentary loneliness and optimism, we performed propensity matching to align the moderator+single user and moderator+small group chat cohorts and then compare the emotion trends between the matched cohorts.

Results: Loneliness and optimism trends significantly improved after 8 (P=.02) to 9 minutes (P=.03) into the chat. We observed a significant improvement in the momentary loneliness and optimism trends between the moderator+small group compared to the moderator+single user chat cohort after 19 (P=.049) and 21 minutes (P=.04) for optimism and loneliness, respectively.

Conclusions: Chat-based peer support may be a viable intervention to help address momentary loneliness in older adults and present an alternative to traditional care. The promising results support the need for further study to expand the evidence for such cost-effective options.

背景:老年人的孤独率很高,这会导致社会心理风险、医疗发病率和死亡率增加。数字情感支持干预为获得额外支持提供了方便快捷的途径。针对情感挣扎的数字同伴支持干预措施与通常的以提供者为基础的临床护理模式形成了鲜明对比,因为它们提供了更方便、更直接的赋权支持,突出了用户的自主性、能力和相关性:本研究旨在探讨一种新型的匿名同步点对点数字聊天服务,该服务由训练有素的人工主持人提供帮助。我们对 699 名年龄≥65 岁的成年人的经历进行了分析,以确定:(1) 单独参与是否会导致瞬间孤独感和乐观情绪发生可测量的总体变化;(2) 同伴对瞬间孤独感和乐观情绪的影响:方法:每个参与者都会被问到一个问题:"你的挣扎是什么?"利用专有的人工智能模型,自由文本回复会根据受访者自我表达的情感挣扎自动将其与同伴和聊天主持人进行匹配。使用第三方公开自然语言处理模型(GPT-4 [OpenAI])对交换的信息进行分析,以定量测量瞬间孤独感和乐观情绪的变化。情绪变化分析最初是在个人层面上进行的,然后对具有相似情绪类型的所有用户进行平均,以得出具有统计学意义的结果(PResults:在聊天开始 8 分钟(P=.02)到 9 分钟(P=.03)后,孤独感和乐观趋势明显改善。我们观察到,在 19 分钟(P=.049)和 21 分钟(P=.04)之后,与主持人+单个用户聊天群组相比,主持人+小型群组的瞬间孤独感和乐观情绪趋势有了明显改善:基于聊天的同伴支持可能是一种可行的干预措施,有助于解决老年人一时的孤独感,是传统护理的一种替代方案。这些有希望的结果支持了进一步研究的必要性,以扩大这种具有成本效益的选择的证据。
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引用次数: 0
Occurrence of Stigmatizing Documentation Among Hospital Medicine Encounters With Opioid-Related Diagnosis Codes: Cohort Study. 带有阿片类药物相关诊断代码的医院就诊病例中出现污名化文档的情况:队列研究。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-24 DOI: 10.2196/53510
William S Bradford, Reed W R Bratches, Hollie Porras, David R Chen, Kelly W Gagnon, Simon B Ascher

Background: Physician use of stigmatizing language in the clinical documentation of hospitalized adults with opioid use is common. However, patient factors associated with stigmatizing language in this setting remain poorly characterized.

Objective: This study aimed to determine whether specific demographic factors and clinical outcomes are associated with the presence of stigmatizing language by physicians in the clinical documentation of encounters with opioid-related ICD-10 (International Statistical Classification of Diseases, Tenth Revision) codes.

Methods: Hospital encounters with one or more associated opioid-related ICD-10 admission diagnoses on the hospital medicine service during the 2020 calendar year were analyzed for the presence of stigmatizing language in history and physical and discharge summaries. Multivariable adjusted logistic regression models were used to determine associations of age, race, gender, medication for addiction treatment use, against medical advice discharge, homelessness, comorbid polysubstance use, comorbid psychiatric disorder, comorbid chronic pain, cost, and 30-day readmission with the presence of stigmatizing language.

Results: A total of 221 encounters were identified, of which 64 (29%) encounters had stigmatizing language present in physician documentation. Most stigmatizing language was due to use of "substance abuse" rather than the preferred term "substance use" (63/66 instances). Polysubstance use and homelessness were independently associated with the presence of stigmatizing language (adjusted odds ratio [aOR] 7.83; 95% CI 3.42-19.24 and aOR 2.44; 95% CI 1.03-5.90) when controlling for chronic pain and other covariates.

Conclusions: Among hospital medicine encounters with an opioid-related diagnosis, stigmatizing language by physicians in clinical documentation was common and independently associated with comorbid polysubstance use and homelessness.

背景:医生在对使用阿片类药物的住院成人进行临床记录时使用鄙视性语言的情况很常见。然而,在这种情况下与鄙视性语言相关的患者因素仍然很少:本研究旨在确定特定的人口统计学因素和临床结果是否与医生在临床记录中使用与阿片类药物相关的 ICD-10(国际疾病统计分类第十版)代码的鄙视性语言有关。方法:对 2020 日历年度医院内科服务中使用一个或多个与阿片类药物相关的 ICD-10 入院诊断的住院病例进行分析,以确定病史、体格检查和出院摘要中是否存在鄙视性语言。使用多变量调整逻辑回归模型来确定年龄、种族、性别、成瘾治疗用药、出院医嘱、无家可归、合并多种药物使用、合并精神障碍、合并慢性疼痛、费用和 30 天再入院与是否存在污名化语言之间的关系:共发现 221 例病例,其中 64 例(29%)病例的医生记录中存在鄙视性语言。大多数污名化语言是由于使用了 "药物滥用 "而非首选术语 "药物使用"(63/66 例)。在控制慢性疼痛和其他协变量的情况下,多种物质的使用和无家可归与鄙视性语言的存在有独立的关联(调整后的几率比 [aOR] 7.83; 95% CI 3.42-19.24 和 aOR 2.44; 95% CI 1.03-5.90):在医院就诊的阿片类药物相关诊断患者中,医生在临床文件中使用污名化语言的情况很常见,并且与合并多种药物使用和无家可归有独立关联。
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引用次数: 0
Cadence-Based Pedometer App With Financial Incentives to Enhance Moderate-to-Vigorous Physical Activity: Development and Single-Arm Feasibility Study. 基于步频的计步器应用程序,通过经济激励来加强中等强度到高强度的体育锻炼:开发和单臂可行性研究。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-24 DOI: 10.2196/56376
Kosuke Hayashi, Hiromitsu Imai, Ichiro Oikawa, Yugo Ishihara, Hirokazu Wakuda, Iori Miura, Shingo Uenohara, Asuka Kuwae, Megumi Kai, Ken'ichi Furuya, Naoto Uemura

Background: High levels of physical activity are key to improving health outcomes, yet many people fail to take action. Using pedometers to target steps per day and providing financial incentives is a simple and scalable approach to promoting public health. However, conventional pedometers do not account for "intensity" and "duration," making it challenging to efficiently increase people's moderate-to-vigorous physical activity (MVPA), which is expected to improve health outcomes. Based on these rationales, we developed a smartphone app that sets step cadence as a goal (defined as a daily challenge of walking more than 1500 steps in 15 minutes twice a day, which is a heuristic threshold for moderate physical activity) and provides financial incentive when the challenge is met.

Objective: This study aimed to evaluate the feasibility of our novel app and explore whether its use can increase users' daily MVPA.

Methods: A single-arm pre-post study evaluated the feasibility and efficacy of the app. A total of 15 participants used app 1 (an app without financial incentives) for the first period (4 weeks) and then switched to app 2 (an app with financial incentives) for the second period (4 weeks). The primary outcome was the difference between the first and second periods in the number of successful challenge attempts per week. Secondary outcomes were differences between the first and second periods in daily steps and distance walked. Exploratory outcomes included the difference between the first and second periods in daily "heart points" as measured by Google Fit, a publicly available app that measures users' daily MVPA.

Results: The number of successful challenge attempts per week increased significantly compared to the first period (5.6 times per week vs 0.7 times per week; P<.001). Although not statistically significant, there was a trend toward an increase in the mean steps per day and distance walked per day (6586 steps per day vs 5950 steps per day; P=.19; and 4.69 km per day vs 3.85 km per day; P=.09, respectively). An exploratory end point examining daily MVPA by "heart points" collected from Google Fit also showed a significant increase compared to the first period (22.7 points per day vs 12.8 points per day; P=.02).

Conclusions: Our app using step cadence as a goal and providing financial incentives seemed feasible and could be an effective app to increase users' daily MVPA. Based on the results of this study, we are motivated to conduct a confirmatory study with a broader and larger number of participants.

Trial registration: UMIN 000050518; https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000057420.

背景:高水平的体育锻炼是改善健康状况的关键,但许多人却未能付诸行动。使用计步器设定每天的目标步数并提供经济奖励,是促进公众健康的一种简单而可扩展的方法。然而,传统的计步器并不考虑 "强度 "和 "持续时间",因此要有效地增加人们的中到剧烈运动(MVPA),从而改善健康状况,具有一定的挑战性。基于这些理由,我们开发了一款智能手机应用程序,将步速设定为目标(定义为每天挑战两次,每次 15 分钟内步行超过 1500 步,这是启发式的中等体力活动阈值),并在完成挑战后提供经济激励:本研究旨在评估我们的新型应用程序的可行性,并探讨使用该应用程序能否增加用户的日常 MVPA:方法:单臂前-后研究评估了该应用的可行性和有效性。共有 15 名参与者在第一阶段(4 周)使用应用程序 1(无经济激励的应用程序),然后在第二阶段(4 周)改用应用程序 2(有经济激励的应用程序)。主要结果是第一阶段和第二阶段每周挑战成功次数的差异。次要结果是第一期和第二期之间每日步数和行走距离的差异。探索性结果包括第一阶段和第二阶段之间每天 "心脏点数 "的差异,该数据由谷歌 Fit(一款可测量用户每天 MVPA 的公开应用)测量:结果:与第一阶段相比,每周挑战成功的次数显著增加(每周 5.6 次 vs 每周 0.7 次;PC 结论:我们的应用使用步频作为跑步的节奏,并将其作为跑步的动力:我们的应用程序以步频为目标,并提供经济奖励,这似乎是可行的,可以成为提高用户日常 MVPA 的有效应用程序。基于这项研究的结果,我们有动力在更广泛和更多的参与者中开展一项确认性研究:umin 000050518; https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000057420.
{"title":"Cadence-Based Pedometer App With Financial Incentives to Enhance Moderate-to-Vigorous Physical Activity: Development and Single-Arm Feasibility Study.","authors":"Kosuke Hayashi, Hiromitsu Imai, Ichiro Oikawa, Yugo Ishihara, Hirokazu Wakuda, Iori Miura, Shingo Uenohara, Asuka Kuwae, Megumi Kai, Ken'ichi Furuya, Naoto Uemura","doi":"10.2196/56376","DOIUrl":"10.2196/56376","url":null,"abstract":"<p><strong>Background: </strong>High levels of physical activity are key to improving health outcomes, yet many people fail to take action. Using pedometers to target steps per day and providing financial incentives is a simple and scalable approach to promoting public health. However, conventional pedometers do not account for \"intensity\" and \"duration,\" making it challenging to efficiently increase people's moderate-to-vigorous physical activity (MVPA), which is expected to improve health outcomes. Based on these rationales, we developed a smartphone app that sets step cadence as a goal (defined as a daily challenge of walking more than 1500 steps in 15 minutes twice a day, which is a heuristic threshold for moderate physical activity) and provides financial incentive when the challenge is met.</p><p><strong>Objective: </strong>This study aimed to evaluate the feasibility of our novel app and explore whether its use can increase users' daily MVPA.</p><p><strong>Methods: </strong>A single-arm pre-post study evaluated the feasibility and efficacy of the app. A total of 15 participants used app 1 (an app without financial incentives) for the first period (4 weeks) and then switched to app 2 (an app with financial incentives) for the second period (4 weeks). The primary outcome was the difference between the first and second periods in the number of successful challenge attempts per week. Secondary outcomes were differences between the first and second periods in daily steps and distance walked. Exploratory outcomes included the difference between the first and second periods in daily \"heart points\" as measured by Google Fit, a publicly available app that measures users' daily MVPA.</p><p><strong>Results: </strong>The number of successful challenge attempts per week increased significantly compared to the first period (5.6 times per week vs 0.7 times per week; P<.001). Although not statistically significant, there was a trend toward an increase in the mean steps per day and distance walked per day (6586 steps per day vs 5950 steps per day; P=.19; and 4.69 km per day vs 3.85 km per day; P=.09, respectively). An exploratory end point examining daily MVPA by \"heart points\" collected from Google Fit also showed a significant increase compared to the first period (22.7 points per day vs 12.8 points per day; P=.02).</p><p><strong>Conclusions: </strong>Our app using step cadence as a goal and providing financial incentives seemed feasible and could be an effective app to increase users' daily MVPA. Based on the results of this study, we are motivated to conduct a confirmatory study with a broader and larger number of participants.</p><p><strong>Trial registration: </strong>UMIN 000050518; https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000057420.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"8 ","pages":"e56376"},"PeriodicalIF":2.0,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11544333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500822","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}
引用次数: 0
Accuracy of a Smart Diaper System for Nursing Home Residents for Automatically Detecting Voided Volume: Instrument Validation Study. 养老院居民智能尿布系统自动检测排尿量的准确性:仪器验证研究。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-24 DOI: 10.2196/58583
Jae Heon Kim, Ui Cheol Lee, Byeong Hun Jeong, Byeong Uk Kang, Sung Ryul Shim, In Gab Jeong

Background: Diapers are commonly used by older patients with urination disorders. A smart diaper system (SDS) may be able to estimate the weight of urine comparably to conventional measurements made by weighing diapers.

Objective: The aim of the current research is to determine the degree of accuracy of an SDS technology specifically designed for the management of urination routines and the use of incontinence pads in older adults.

Methods: From January to December 2022, 97 older patients with at least 1 chronic disease from 3 nursing homes were included. In this study, the SDS was used for 1 month per patient after obtaining their consent; all patients originally used traditional diapers in the nursing home. The index test measured the change in electrical resistance of the SDS and the reference test measured the change in actual urine weight. When measuring the actual urine weight, the degree of absorption was directly confirmed with the naked eye because the expression value varied according to pressure changes caused by the user's movement or position. The Pearson correlation was used to determine the correlation between the 2 test methods, the intraclass correlation coefficient (ICC) was used to check the degree of agreement between the evaluators, and the Bland-Altman test was used to confirm whether there was a significant difference between the 2 test methods.

Results: The average age of the 97 participants was 86.48 (SD 6.26) years, with 10 men and 87 women. There were 73 patients (75%) with hypertension, 86 patients (88%) with dementia, and 86 patients (88%) with 2 or more comorbidities, accounting for the majority. The Pearson correlation coefficient and ICC were 0.971 and 0.985 (P<.001). In the Bland-Altman figure, the difference in the mean between the 2 tests was evenly scattered without showing a specific pattern, indicating that the SDS and actual urine weight were very consistent. The difference between the mean of the 2 tests was -0.045 of the standardized mean difference, and all measurements were located within the 95% CI, so this confirms that the 2 test methods are equivalent.

Conclusions: Our study showed a fairly high correlation coefficient and ICC for all patient groups, which reveals that the 2 tests were very consistent and that the SDS can replace traditional diapers, even in a real clinical setting. This study shows the possibility that heath care professionals could be alerted by the SDS to the need for pad replacement due to incontinence, thus avoiding the development of dermatological complications.

背景:有排尿障碍的老年患者通常使用尿布。智能尿布系统(SDS)可以估算出尿液的重量,与传统的尿布称重测量方法相当:本研究旨在确定专为老年人排尿程序管理和尿失禁垫使用而设计的 SDS 技术的准确度:方法:2022 年 1 月至 12 月,3 家养老院共纳入了 97 名至少患有一种慢性疾病的老年患者。在本研究中,在征得患者同意后,每位患者使用 SDS 1 个月;所有患者最初在疗养院都使用传统尿布。指标测试测量的是 SDS 电阻的变化,参考测试测量的是实际尿液重量的变化。在测量实际尿液重量时,直接用肉眼确认吸收程度,因为表达值会随着使用者的动作或姿势引起的压力变化而变化。使用皮尔逊相关性来确定两种测试方法之间的相关性,使用类内相关系数(ICC)来检验评估者之间的一致程度,使用布兰-阿尔特曼检验来确认两种测试方法之间是否存在显著差异:97 名参与者的平均年龄为 86.48 岁(标准差为 6.26 岁),其中男性 10 人,女性 87 人。高血压患者有 73 人(占 75%),痴呆患者有 86 人(占 88%),有 2 种或 2 种以上合并症的患者有 86 人(占 88%),占大多数。皮尔逊相关系数和 ICC 分别为 0.971 和 0.985(PConclusions:我们的研究显示,所有患者群体的相关系数和 ICC 都相当高,这表明这两种测试非常一致,即使在真实的临床环境中,SDS 也能取代传统尿布。这项研究表明,卫生保健专业人员有可能通过 SDS 发现尿失禁患者需要更换尿垫,从而避免皮肤病并发症的发生。
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引用次数: 0
Aligning Large Language Models for Enhancing Psychiatric Interviews Through Symptom Delineation and Summarization: Pilot Study. 对齐大型语言模型,通过症状划分和总结加强精神科访谈:试点研究。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-24 DOI: 10.2196/58418
Jae-Hee So, Joonhwan Chang, Eunji Kim, Junho Na, JiYeon Choi, Jy-Yong Sohn, Byung-Hoon Kim, Sang Hui Chu
<p><strong>Background: </strong>Recent advancements in large language models (LLMs) have accelerated their use across various domains. Psychiatric interviews, which are goal-oriented and structured, represent a significantly underexplored area where LLMs can provide substantial value. In this study, we explore the application of LLMs to enhance psychiatric interviews by analyzing counseling data from North Korean defectors who have experienced traumatic events and mental health issues.</p><p><strong>Objective: </strong>This study aims to investigate whether LLMs can (1) delineate parts of the conversation that suggest psychiatric symptoms and identify those symptoms, and (2) summarize stressors and symptoms based on the interview dialogue transcript.</p><p><strong>Methods: </strong>Given the interview transcripts, we align the LLMs to perform 3 tasks: (1) extracting stressors from the transcripts, (2) delineating symptoms and their indicative sections, and (3) summarizing the patients based on the extracted stressors and symptoms. These 3 tasks address the 2 objectives, where delineating symptoms is based on the output from the second task, and generating the summary of the interview incorporates the outputs from all 3 tasks. In this context, the transcript data were labeled by mental health experts for the training and evaluation of the LLMs.</p><p><strong>Results: </strong>First, we present the performance of LLMs in estimating (1) the transcript sections related to psychiatric symptoms and (2) the names of the corresponding symptoms. In the zero-shot inference setting using the GPT-4 Turbo model, 73 out of 102 transcript segments demonstrated a recall mid-token distance d<20 for estimating the sections associated with the symptoms. For evaluating the names of the corresponding symptoms, the fine-tuning method demonstrates a performance advantage over the zero-shot inference setting of the GPT-4 Turbo model. On average, the fine-tuning method achieves an accuracy of 0.82, a precision of 0.83, a recall of 0.82, and an F1-score of 0.82. Second, the transcripts are used to generate summaries for each interviewee using LLMs. This generative task was evaluated using metrics such as Generative Evaluation (G-Eval) and Bidirectional Encoder Representations from Transformers Score (BERTScore). The summaries generated by the GPT-4 Turbo model, utilizing both symptom and stressor information, achieve high average G-Eval scores: coherence of 4.66, consistency of 4.73, fluency of 2.16, and relevance of 4.67. Furthermore, it is noted that the use of retrieval-augmented generation did not lead to a significant improvement in performance.</p><p><strong>Conclusions: </strong>LLMs, using either (1) appropriate prompting techniques or (2) fine-tuning methods with data labeled by mental health experts, achieved an accuracy of over 0.8 for the symptom delineation task when measured across all segments in the transcript. Additionally, they attained a G-Eval score of
背景:大型语言模型(LLM)的最新进展加速了其在各个领域的应用。精神病学访谈是以目标为导向的结构化访谈,在这一领域中,LLMs 可提供巨大的价值,但对这一领域的探索明显不足。在本研究中,我们通过分析经历过创伤事件和心理健康问题的朝鲜脱北者的咨询数据,探索如何应用 LLMs 来增强心理访谈:本研究旨在探讨 LLMs 是否能够(1)划分对话中暗示精神症状的部分并识别这些症状,以及(2)根据访谈对话记录总结压力源和症状:给定访谈记录后,我们让 LLMs 执行 3 项任务:(1) 从记录中提取压力源;(2) 划分症状及其指示性部分;(3) 根据提取的压力源和症状对患者进行总结。这 3 项任务实现了 2 个目标,其中症状的划分是基于第二项任务的输出结果,而访谈摘要的生成则包含了所有 3 项任务的输出结果。在这种情况下,笔录数据由心理健康专家进行标注,以便对 LLM 进行培训和评估:首先,我们介绍了 LLMs 在估算(1)与精神症状相关的文字记录部分和(2)相应症状名称方面的表现。在使用 GPT-4 Turbo 模型进行零次推理的情况下,102 个语段中有 73 个语段的召回中标记词距离为 dConclusions:使用(1)适当的提示技术或(2)由心理健康专家标注数据的微调方法,在对所有片段进行测量时,LLMs 在症状划分任务中的准确率超过了 0.8。此外,他们在总结任务中的一致性也达到了超过 4.6 的 G-Eval 分数。这项研究为在精神科访谈中应用 LLMs 这一新兴领域做出了贡献,并证明了 LLMs 在协助心理健康从业人员方面的潜在有效性。
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引用次数: 0
Development and Initial Evaluation of a Digital Phenotype Collection System for Adolescents: Proof-of-Concept Study. 青少年数字表型收集系统的开发和初步评估:概念验证研究。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-24 DOI: 10.2196/59623
Minseo Cho, Doeun Park, Myounglee Choo, Jinwoo Kim, Doug Hyun Han

Background: The growing concern on adolescent mental health calls for proactive early detection and intervention strategies. There is a recognition of the link between digital phenotypes and mental health, drawing attention to their potential use. However, the process of collecting digital phenotype data presents challenges despite its promising prospects.

Objective: This study aims to develop and validate system concepts for collecting adolescent digital phenotypes that effectively manage inherent challenges in the process.

Methods: In a formative investigation (N=34), we observed adolescent self-recording behaviors and conducted interviews to develop design goals. These goals were then translated into system concepts, which included planners resembling interfaces, simplified data input with tags, visual reports on behaviors and moods, and supportive ecological momentary assessment (EMA) prompts. A proof-of-concept study was conducted over 2 weeks (n=16), using tools that simulated the concepts to record daily activities and complete EMA surveys. The effectiveness of the system was evaluated through semistructured interviews, supplemented by an analysis of the frequency of records and responses.

Results: The interview findings revealed overall satisfaction with the system concepts, emphasizing strong support for self-recording. Participants consistently maintained daily records throughout the study period, with no missing data. They particularly valued the recording procedures that aligned well with their self-recording goal of time management, facilitated by the interface design and simplified recording procedures. Visualizations during recording and subsequent report viewing further enhanced engagement by identifying missing data and encouraging deeper self-reflection. The average EMA compliance reached 72%, attributed to a design that faithfully reflected adolescents' lives, with surveys scheduled at convenient times and supportive messages tailored to their daily routines. The high compliance rates observed and positive feedback from participants underscore the potential of our approach in addressing the challenges of collecting digital phenotypes among adolescents.

Conclusions: Integrating observations of adolescents' recording behavior into the design process proved to be beneficial for developing an effective and highly compliant digital phenotype collection system.

背景:青少年心理健康问题日益受到关注,这就要求我们采取积极的早期检测和干预策略。人们已经认识到数字表型与心理健康之间的联系,并开始关注数字表型的潜在用途。然而,尽管数字表型数据前景广阔,但其收集过程却面临挑战:本研究旨在开发和验证用于收集青少年数字表型的系统概念,以有效管理收集过程中固有的挑战:在一项形成性调查(N=34)中,我们观察了青少年的自我记录行为并进行了访谈,以制定设计目标。然后将这些目标转化为系统概念,其中包括类似于界面的规划器、带标签的简化数据输入、关于行为和情绪的可视化报告以及支持性生态瞬间评估(EMA)提示。使用模拟这些概念的工具记录日常活动和完成 EMA 调查,进行了为期两周的概念验证研究(人数=16)。通过半结构式访谈评估了该系统的有效性,并对记录和回复的频率进行了分析:访谈结果显示,参与者对系统概念总体满意,并对自我记录表示大力支持。在整个研究期间,参与者始终坚持每天进行记录,没有遗漏数据。他们特别看重记录程序,认为这与他们自我记录的时间管理目标非常吻合,界面设计和简化的记录程序也为他们提供了便利。记录过程中的可视化和随后的报告查看通过识别缺失数据和鼓励更深入的自我反思,进一步提高了参与度。EMA 的平均达标率为 72%,这要归功于忠实反映青少年生活的设计,即在方便的时间安排调查,并根据他们的日常习惯提供支持性信息。观察到的高依从率和参与者的积极反馈强调了我们的方法在应对收集青少年数字表型挑战方面的潜力:事实证明,将对青少年记录行为的观察融入到设计过程中,有利于开发有效且符合性高的数字表型收集系统。
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引用次数: 0
Evaluating a WeChat-Based Intervention to Enhance Influenza Vaccination Knowledge, Attitude, and Behavior Among Chinese University Students Residing in the United Kingdom: Controlled, Quasi-Experimental, Mixed Methods Study. 评估基于微信的干预措施,以提高留英中国大学生的流感疫苗接种知识、态度和行为:受控、准实验、混合方法研究。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-24 DOI: 10.2196/55706
Lan Li, Caroline E Wood, Patty Kostkova

Background: University students, who often live in close quarters and engage in frequent social interaction, face a heightened risk of influenza morbidity. Still, vaccination rates among this group, particularly Chinese students, remain consistently low due to limited awareness and insufficient access to vaccinations.

Objective: This study examines the effectiveness of a cocreated WeChat-based intervention that targets mainland Chinese university students in the United Kingdom, aiming to improve their knowledge, attitude, and behavior (KAB) toward seasonal influenza vaccination.

Methods: A quasi-experimental mixed methods design was used, incorporating an intervention and comparison group, with baseline and follow-up self-reported surveys. The study was conducted from December 19, 2022, to January 16, 2023. The primary outcome is the KAB score, which was measured before and after the intervention phases. System-recorded data and user feedback were included in the analysis as secondary outcomes. A series of hypothesis testing methods were applied to test the primary outcomes, and path analysis was used to explore the relationships.

Results: Our study included 596 students, of which 303 (50.8%) were in the intervention group and 293 (49.2%) were in the control group. The intervention group showed significant improvements in knowledge, attitude, and intended behavior scores over time, whereas the control group had only a slight increase in intended behavior scores. When comparing changes between the 2 groups, the intervention group displayed significant differences in knowledge and attitude scores compared to the control group, while intended behavior scores did not significantly differ. After the intervention, the actual vaccination rate was slightly higher in the intervention group (63/303, 20.8%) compared to the control group (54/293, 18.4%). Path analysis found that the intervention had a significant direct impact on knowledge but not on attitudes; knowledge strongly influenced attitudes, and both knowledge and attitudes significantly influenced intended behavior; and there was a strong correlation between intended and actual behavior. In the intervention group, participants expressed a high level of satisfaction and positive review of the content and its use.

Conclusions: This study demonstrates how a WeChat intervention effectively improves KAB related to seasonal influenza vaccination among Chinese students, highlighting the potential of social media interventions to drive vaccination behavior change. It contributes to the broader research on digital health intervention effectiveness and lays the groundwork for tailoring similar interventions to different health contexts and populations.

背景:大学生通常住得很近,社交活动频繁,他们面临着更高的流感发病风险。然而,由于对疫苗接种的认识有限和接种途径不足,这一群体,尤其是中国学生的疫苗接种率一直很低:本研究探讨了以中国大陆在英大学生为对象、基于微信的共同创作干预措施的有效性,旨在改善他们对季节性流感疫苗接种的知识、态度和行为(KAB):采用准实验混合方法设计,包括干预组和对比组,以及基线和后续自我报告调查。研究时间为 2022 年 12 月 19 日至 2023 年 1 月 16 日。主要结果是 KAB 分数,在干预阶段前后进行测量。系统记录的数据和用户反馈作为次要结果纳入分析。我们采用了一系列假设检验方法来检验主要结果,并使用路径分析来探索其中的关系:我们的研究包括 596 名学生,其中干预组 303 人(50.8%),对照组 293 人(49.2%)。随着时间的推移,干预组在知识、态度和预期行为方面的得分都有明显提高,而对照组在预期行为方面的得分仅略有增加。在比较两组之间的变化时,干预组的知识和态度得分与对照组相比有显著差异,而预期行为得分则没有显著差异。干预后,干预组的实际接种率(63/303,20.8%)略高于对照组(54/293,18.4%)。路径分析发现,干预对知识有显著的直接影响,但对态度没有影响;知识对态度有很大影响,知识和态度都对预期行为有显著影响;预期行为和实际行为之间有很强的相关性。在干预组中,参与者对内容及其使用表示了高度的满意和积极的评价:本研究展示了微信干预如何有效改善中国学生接种季节性流感疫苗相关的KAB,凸显了社交媒体干预在推动疫苗接种行为改变方面的潜力。该研究为更广泛的数字健康干预效果研究做出了贡献,并为针对不同的健康环境和人群定制类似的干预措施奠定了基础。
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