Background: Kazakhstan has lacked validated tools to comprehensively assess physicians' perceptions, usability, and perceived effectiveness of telemedicine services. International frameworks such as the Telehealth Usability Questionnaire (TUQ) and the Model for Assessment of Telemedicine (MAST) have not previously been adapted to the national clinical and organizational context.
Objective: This study aims to develop and validate TUQ-MAST-KZ, a Kazakhstan-adapted questionnaire integrating components of the TUQ and MAST models to assess physicians' perceptions, usability, and effectiveness of telemedicine services.
Methods: A multiphase study was conducted, including literature review, questionnaire development, linguistic and cultural adaptation, expert content validity assessment, and pilot testing. An online survey (Google Forms) was administered to 156 physicians representing different regions and levels of health care delivery in Kazakhstan. Internal consistency (Cronbach α) and content validity indices were calculated. Additional evaluations covered clarity, structure, and practical applicability.
Results: The final TUQ-MAST-KZ instrument contains 27 items capturing technological, clinical, organizational, and behavioral dimensions of telemedicine use. The scale demonstrated high content validity (scale-level content validity index=0.94). Internal consistency was excellent, with an overall Cronbach α of 0.924. Respondents reported that the questionnaire was clearly structured, easy to complete, and relevant to clinical practice. Organizational items identified key barriers to telemedicine adoption, including limited infrastructure, insufficient managerial support, and the need for additional training.
Conclusions: TUQ-MAST-KZ is a valid, reliable, and practice-oriented instrument for assessing physicians' perceptions of telemedicine services in Kazakhstan. It can support digital health monitoring, implementation analysis, educational planning, and policy development. Future studies should evaluate its applicability across broader samples and diverse clinical specialties.
Background: Depression, anxiety, and cognitive decline are prevalent concerns among older adults and can negatively affect their well-being. Pet ownership has been proposed as a potential protective factor, but inconsistencies remain in the current literature.
Objective: The study aims to compare symptoms of depression, anxiety, and levels of psychological well-being between older pet owners and non-pet owners. Additionally, we compared the cognitive functioning and cognitive reserve between these 2 groups of older individuals.
Methods: This cross-sectional study included 215 community-dwelling older adults aged ≥59 years (mean 69.13, SD 6.89). Participants completed a sociodemographic questionnaire, the Modified Telephone Interview for Cognitive Status, Cognitive Reserve Index Questionnaire, Mental Health Continuum-Short Form, Geriatric Depression Scale-15, and Geriatric Anxiety Inventory. The data were collected via video calls through WhatsApp and analyzed using the JASP software. Group comparisons (pet owners vs nonowners) were conducted using the Mann-Whitney U test, followed by rank-biserial correlation for effect sizes (α=.05).
Results: The sample consisted of 114 (53.0%) older adults pet owners and 101 (46.9%) older adults who did not own pets. Among the pet owners, 77.2% (n=88) were female, and 57.9% (n=66) were married or in common-law marriages. In the non-pet owners' group, 71.3% (n=72) were female, and 46.5% (n=47) were married or in common-law marriages. Pet owners showed lower depression symptoms (Geriatric Depression Scale-15: mean 2.33 vs 3.00 non-owners; U=4714, P=.02; rb=-0.18, 95% CI -0.326 to -0.028), indicating a small effect. No significant group differences were observed for anxiety (Geriatric Anxiety Inventory: mean 5.33 vs 4.92, P=.52), psychological well-being (Mental Health Continuum-Short Form: mean 68.21 vs 67.46, P=.43), cognitive performance (Modified Telephone Interview for Cognitive Status: mean 24.74 vs 24.30, P=.60), or cognitive reserve (Cognitive Reserve Index Questionnaire: mean 123.82 vs 123.28, P=.95).
Conclusions: The pet owner group presents fewer symptoms of depression in comparison to the non-pet owner group. Although no differences were observed in anxiety, well-being, cognitive functioning, or cognitive reserve, these findings suggest that pet companionship correlates with better emotional outcomes in later life. Future longitudinal studies are needed to clarify causal pathways and examine whether the frequency and quality of interactions with pets influence these outcomes.
Background: : Although mobile health (mHealth) apps for tobacco cessation augment traditional cessation methods and have contributed to increases in cessation rates, Black adults are under-represented in mHealth app studies for tobacco cessation. As a result, their mHealth app preferences are not well known.
Objective: Our goal was to identify features of mHealth apps for cessation that are important to Black adults who use tobacco products.
Methods: We developed an online discrete choice experiment with 12 pairs of hypothetical mHealth apps for tobacco cessation. Participants included: age > 21 years, current use of any tobacco product, and identifying as Black or African American. Participants had to be interested in tobacco cessation and have a history of mHealth app usage or be willing to use one in the future. From each pair of hypothetical apps within the survey, participants had to choose the app they preferred. Each hypothetical app was made up of seven features developed from existing mHealth literature and prior qualitative work: graphics, marketing, strategies for quitting, connection with others, personalization, benefits of quitting, and health information. Each feature had up to 4 -5 levels (i.e., variations of that attribute), and each hypothetical mHealth app was comprised of a random assortment of levels of features. Hierarchical Bayes estimation was used to determine the part-worth utility for each level within each feature for each participant, which was then used to calculate the importance score. Average.
Results: We had 901 adults participants. The mean age was 41 (SD 14.02), and 377 (42%) were female. Two thirds of participants (549/901, 61%) had used an mHealth app in the past, and the great majority (786/901, 87%) indicated a willingness to use an app for health purposes in the future. The features had the following importance: graphics (16.5%); marketing (15.1%); strategies for quitting (15.0%); connection with others (14.3%); personalization (13.4%); benefits of quitting (13.1%) and health information (12.6%). Within features, strategies for quitting had the highest and third-highest levels of "making a step-by-step quit plan" and "recommendations to manage relapse or withdrawal" respectively. Marketing had the second highest level of "HBCU-endorsed app." Graphics had the fourth highest level of " short video testimonials from people who successfully quit" while connection with others had the fifth highest level of "quit buddy program for support and accountability."
Conclusions: This study identified features of mHealth apps important to Black adult tobacco users. To enhance the appeal of mHealth apps to such adults, prioritizing inclusion of highly preferred levels in apps may lead to higher usage and improved cessation.
Clinicaltrial:
Unlabelled: This cross-sectional survey of a California medical school found that caffeine consumption increases across medical training, with third-year students consuming more caffeine, particularly from coffee, energy drinks, and over-the-counter stimulants, than first- and second-year students, and higher intake being associated with elevated modified CAGE scores, suggesting stress-related stimulant use.
Background: Cancer-related cognitive decline (CRCD) is a significant problem; interventions are needed to mitigate CRCD for older adults (aged ≥65 years).
Objective: Our objective was to develop and evaluate the usability of Memory and Attention Adaptation Training-Geriatrics (MAAT-G), a CRCD intervention for older adults with breast cancer undergoing systemic treatment.
Methods: We conducted an intervention adaptation study to develop MAAT-G. MAAT-G is a cognitive behavioral therapy-based intervention delivered by a health professional over the course of 10 weekly individual workshops via videoconferencing. To develop MAAT-G, the contextual, cohort-based, maturity, and specific challenge framework was used for preliminary adaptations. Patient advocate collaborators guided further refinement, reviewing MAAT-G workshop content, the participant workbook, and intervention delivery via videoconferencing to optimize relevance and usability for older adults. The usability of MAAT-G and its videoconferencing delivery were subsequently evaluated in 4 older adults with breast cancer using the System Usability Scale (score range 0-100; >67 being above average) and through semistructured qualitative interviews.
Results: Numerous adaptations were made to address the unique needs of older patients using the contextual, cohort-based, maturity, and specific challenge framework and patient advocate feedback. Usability testing included 4 female patients with breast cancer (mean age 73.3, SD 3.77; range 67-77 years). Patients were receiving systemic therapy (2 receiving adjuvant therapy and 2 receiving advanced-stage disease therapy). One patient had an educational level lower than high school; 3 had some college education or higher. All 4 patients completed study procedures, including 10 MAAT-G workshop sessions (100% intervention adherence). The mean System Usability Scale score was 90.6 (SD 13.51), indicating good usability.
Conclusions: MAAT-G is a behavioral intervention developed to mitigate CRCD. It is designed specifically for older adults and showed above-average usability in this population.
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