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Considerations When Designing Inclusive Digital Health Solutions for Older Adults Living With Frailty or Impairments. 为体弱或有缺陷的老年人设计包容性数字健康解决方案时的考虑因素。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-21 DOI: 10.2196/63832
Emilie Kauffeldt Wegener, Jenny M Bergschöld, Sverre Bergh, Ad van Berlo, Camilla Wong Schmidt, Afroditi Konidari, Lars Kayser
<p><p>This viewpoint is written by authors with industrial, clinical, and academic backgrounds within medical and social sciences. The purpose is to share our experiences with digital health innovation from a sociotechnical perspective. The audience for the viewpoint is innovators, researchers, service designers, and project managers with little or some experience with theory-informed programs, complex interventions, and implementation or reorganization of sociotechnical ecosystems in health care. In digital health innovation projects, barriers related to traditions and cultures among researchers, clinicians, and industry may arise. Moreover, the final digital solutions may not always fit into existing digital ecosystems and may thus require a reorganization of how health care is provided at horizontal and vertical levels. The collaborating researchers have experience working in the field of digital health innovation for more than a decade, and we have developed and used 4 frameworks and models that are particularly relevant for theory-based complex interventions and can be used to inform inclusive co-design of digital health solutions with a sociotechnical perspective. These are (1) the 4E, a matrix to include, engage, empower, and emancipate marginalized people; (2) the GO-TO model, which can be used as a design navigator; (3) the Epital Care Model, to inform infrastructure; and (4) the Readiness and Enablement Index for Health Technology instrument, to stratify service users. From January 2021 to September 2024, we had the opportunity to apply these into practice in 4 living labs located in Denmark, Norway, the Netherlands, and Canada as a part of a European Union-funded project on "Smart Inclusive Living Environments." The goal was to cocreate a digital solution and reorganize health care services to reduce social isolation, increase health literacy, and enhance well-being for older adults living with frailty or impairments. Based on our experiences with the Smart Inclusive Living Environments project, we have formed a proposal for how design guidelines for sociotechnical innovation projects can be structured, backed up with reflections based on our experiences. With that, design guidelines should include three areas: (1) a common vocabulary including theories, frameworks, and models; (2) templates and protocols for methods, including detailed guidelines and templates for the planned development of the technologies; and (3) methods to implement and provide education and training of service users and informal and formal caregivers. In the design process, we emphasize the importance of involving relevant stakeholders in the implementation of the created design guidelines to obtain preparedness in the organizations, as well as including putative service users to ensure the likelihood of adoption. Moreover, it is important to align expectations, have a common understanding of the applied frameworks and methods, and have access to the necessary re
本观点由具有医学和社会科学领域工业、临床和学术背景的作者撰写。目的是从社会技术的角度分享我们在数字医疗创新方面的经验。该观点的受众是创新者、研究人员、服务设计者和项目经理,他们在医疗保健领域的理论项目、复杂干预措施、社会技术生态系统的实施或重组方面拥有较少或一定的经验。在数字医疗创新项目中,研究人员、临床医生和行业之间可能会出现与传统和文化相关的障碍。此外,最终的数字解决方案可能并不总是适合现有的数字生态系统,因此可能需要在横向和纵向层面对医疗服务的提供方式进行重组。合作研究人员在数字医疗创新领域已有十多年的工作经验,我们开发并使用了 4 个框架和模型,它们与基于理论的复杂干预措施特别相关,可用于从社会技术角度为数字医疗解决方案的包容性共同设计提供信息。它们是:(1) 4E,这是一个包含、参与、赋权和解放边缘化人群的矩阵;(2) GO-TO 模型,可用作设计导航;(3) Epital Care 模型,为基础设施提供信息;(4) 健康技术就绪和启用指数工具,用于对服务用户进行分层。从 2021 年 1 月到 2024 年 9 月,作为欧盟资助的 "智能包容性生活环境 "项目的一部分,我们有机会在丹麦、挪威、荷兰和加拿大的 4 个生活实验室中将这些技术应用于实践。该项目的目标是共同创建一个数字解决方案,并重组医疗保健服务,以减少社会隔离,提高健康素养,并增强体弱或有缺陷的老年人的幸福感。根据我们在智能包容性生活环境项目中的经验,我们就如何构建社会技术创新项目的设计指南提出了建议,并根据我们的经验进行了反思。因此,设计指南应包括三个方面:(1) 包括理论、框架和模型在内的通用词汇;(2) 方法的模板和协议,包括计划开发技术的详细指南和模板;(3) 实施和提供服务用户、非正式和正式护理人员的教育和培训的方法。在设计过程中,我们强调让相关利益方参与实施所创建的设计指南的重要性,以便让各组织做好准备,并让潜在的服务用户参与进来,以确保采用的可能性。此外,重要的是要统一预期,对应用的框架和方法有共同的理解,并获得必要的资源,以取得成功的结果。
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引用次数: 0
The Online Health Information-Seeking Behaviors of People Who Have Experienced Stroke: Qualitative Interview Study. 中风患者的在线健康信息搜索行为:定性访谈研究。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-18 DOI: 10.2196/54827
Brigid Clancy, Billie Bonevski, Coralie English, Ashleigh Guillaumier
<p><strong>Background: </strong>Stroke is a leading cause of death and disability worldwide. As health resources become digitized, it is important to understand how people who have experienced stroke engage with online health information. This understanding will aid in guiding the development and dissemination of online resources to support people after stroke.</p><p><strong>Objective: </strong>This study aims to explore the online health information-seeking behaviors of people who have experienced stroke and any related barriers or navigational needs.</p><p><strong>Methods: </strong>Purposeful sampling was used to recruit participants via email between March and November 2022. The sampling was done from an existing cohort of Australian stroke survivors who had previously participated in a randomized controlled trial of an online secondary prevention program. The cohort consisted of people with low levels of disability. Semistructured one-on-one interviews were conducted via phone or video calls. These calls were audio recorded and transcribed verbatim. The data were analyzed by 2 independent coders using a combined inductive-deductive approach. In the deductive analysis, responses were mapped to an online health information-seeking behavior framework. Inductive thematic analysis was used to analyze the remaining raw data that did not fit within the deductive theoretical framework.</p><p><strong>Results: </strong>A sample of 15 relatively independent, high-functioning people who had experienced stroke from 4 Australian states, aged between 29 and 80 years, completed the interview. A broad range of online health information-seeking behaviors were identified, with most relating to participants wanting to be more informed about medical conditions and symptoms of their own or of a family member or a friend. Barriers included limited eHealth literacy and too much generalization of online information. Online resources were described to be more appealing and more accessible if they were high-quality, trustworthy, easy to use, and suggested by health care providers or trusted family members and friends. Across the interviews, there was an underlying theme of disconnection that appeared to impact not only the participants' online health information seeking, but their overall experience after stroke. These responses were grouped into 3 interrelated subthemes: disconnection from conventional stroke narratives and resources, disconnection from the continuing significance of stroke, and disconnection from long-term supports.</p><p><strong>Conclusions: </strong>People who have experienced stroke actively engage with the internet to search for health information with varying levels of confidence. The underlying theme of disconnection identified in the interviews highlights the need for a more comprehensive and sustained framework for support after stroke beyond the initial recovery phase. Future research should explore the development of tailored and relatable
背景:中风是全球死亡和残疾的主要原因。随着健康资源的数字化,了解中风患者如何使用在线健康信息非常重要。这种了解将有助于指导开发和传播在线资源,为中风患者提供支持:本研究旨在探讨中风患者的在线健康信息搜索行为以及相关障碍或导航需求:在 2022 年 3 月至 11 月期间通过电子邮件有目的抽样招募参与者。抽样是从澳大利亚现有的中风幸存者队列中抽取的,这些幸存者曾参加过一项在线二级预防计划的随机对照试验。该群体由残疾程度较低的人组成。通过电话或视频通话进行了一对一的半结构化访谈。这些通话都进行了录音和逐字记录。数据由两名独立的编码员使用归纳和演绎相结合的方法进行分析。在演绎分析中,回答被映射到在线健康信息搜索行为框架中。归纳主题分析用于分析不符合演绎理论框架的剩余原始数据:来自澳大利亚 4 个州的 15 位年龄在 29 岁至 80 岁之间、相对独立、功能较强的中风患者完成了访谈。访谈发现了广泛的在线健康信息寻求行为,其中大部分与参与者希望更多地了解自己或家人或朋友的病情和症状有关。障碍包括电子健康知识有限和网上信息过于泛化。据描述,如果在线资源质量高、值得信赖、易于使用,并且是由医疗服务提供者或值得信赖的家人和朋友推荐的,那么这些资源就会更有吸引力,也更容易获取。在整个访谈过程中,有一个潜在的主题,即断开连接,这似乎不仅影响了参与者在 网上寻求健康信息,还影响了他们中风后的整体体验。这些反应被归纳为 3 个相互关联的次主题:与传统的中风叙述和资源脱节、与中风的持续意义脱节、与长期支持脱节:结论:经历过中风的人以不同程度的自信积极使用互联网搜索健康信息。在访谈中发现的断开连接这一基本主题突出表明,在中风后的初期恢复阶段之后,需要一个更加全面和持续的支持框架。未来的研究应探索开发有针对性的、可亲近的互联网资源,改善有关中风经历多样性和持续风险的交流和教育,增加长期支持的机会。
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引用次数: 0
Habit and Help-Experiences of Technology Use During the COVID-19 Pandemic: Interview Study Among Older Adults. 在 COVID-19 大流行期间使用技术的习惯和帮助体验:对老年人的访谈研究》(Habit and Help-Experiences of Technology Use during the COVID-19 Pandemic: Interview Study Among Older Adults.
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-18 DOI: 10.2196/58242
Tina R Kilaberia, Yuanyuan Hu, Janice F Bell

Background: The COVID-19 pandemic compelled older adults to engage with technology to a greater extent given emergent public health observance and home-sheltering restrictions in the United States. This study examined subjective experiences of technology use among older adults as a result of unforeseen and widespread public health guidance catalyzing their use of technology differently, more often, or in new ways.

Objective: This study aimed to explore whether older adults scoring higher on the Unified Theory of Acceptance and Use of Technology questionnaire fared better in aspects of technology use, and reported better subjective experiences, in comparison with those scoring lower.

Methods: A qualitative study using prevalence and thematic analyses of data from 18 older adults (mean age 79 years) in 2 groups: 9 scoring higher and 9 scoring lower on the Unified Theory of Acceptance and Use of Technology questionnaire.

Results: Older adults were fairly competent technology users across both higher- and lower-scoring groups. The higher-scoring group noted greater use of technology in terms of telehealth and getting groceries and household items. Cognitive difficulty was described only among the lower-scoring group; they used technology less to get groceries and household items and to obtain health information. Qualitative themes depict the role of habit in technology use, enthusiasm about technology buttressed by the protective role of technology, challenges in technology use, and getting help regardless of technology mastery.

Conclusions: Whereas the pandemic compelled older adults to alter or increase technology use, it did not change their global outlook on technology use. Older adults' prepandemic habits of technology use and available help influenced the degree to which they made use of technology during the COVID-19 pandemic.

背景:COVID-19 大流行迫使老年人在更大程度上使用技术,因为在美国出现了公共卫生观察和家庭避难限制。本研究探讨了老年人使用技术的主观体验,因为不可预见的、广泛的公共卫生指导促使他们以不同的方式、更频繁地或以新的方式使用技术:本研究旨在探讨在 "技术接受与使用统一理论 "问卷中得分较高的老年人与得分较低的老年人相比,是否在技术使用方面表现得更好,并报告了更好的主观体验:对 18 名老年人(平均年龄 79 岁)的数据进行流行率分析和主题分析,将他们分为两组:9 人在接受和使用技术统一理论问卷中得分较高,9 人得分较低:结果:无论是高分组还是低分组,老年人都是相当称职的技术用户。得分较高的一组在远程医疗、购买日用品和家庭用品方面使用科技的程度较高。只有得分较低的组别在认知方面存在困难;他们在购买杂货和家庭用品以及获取健康信息时较少使用技术。定性主题描述了习惯在技术使用中的作用、在技术保护作用的支持下对技术的热情、技术使用中的挑战以及无论是否掌握技术都能获得帮助:尽管大流行迫使老年人改变或增加技术的使用,但并没有改变他们对技术使用的整体看法。老年人在大流行前使用技术的习惯和可获得的帮助影响了他们在 COVID-19 大流行期间使用技术的程度。
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引用次数: 0
Describing the Framework for AI Tool Assessment in Mental Health and Applying It to a Generative AI Obsessive-Compulsive Disorder Platform: Tutorial. 描述心理健康人工智能工具评估框架并将其应用于生成式人工智能强迫症平台:教程。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-18 DOI: 10.2196/62963
Ashleigh Golden, Elias Aboujaoude

As artificial intelligence (AI) technologies occupy a bigger role in psychiatric and psychological care and become the object of increased research attention, industry investment, and public scrutiny, tools for evaluating their clinical, ethical, and user-centricity standards have become essential. In this paper, we first review the history of rating systems used to evaluate AI mental health interventions. We then describe the recently introduced Framework for AI Tool Assessment in Mental Health (FAITA-Mental Health), whose scoring system allows users to grade AI mental health platforms on key domains, including credibility, user experience, crisis management, user agency, health equity, and transparency. Finally, we demonstrate the use of FAITA-Mental Health scale by systematically applying it to OCD Coach, a generative AI tool readily available on the ChatGPT store and designed to help manage the symptoms of obsessive-compulsive disorder. The results offer insights into the utility and limitations of FAITA-Mental Health when applied to "real-world" generative AI platforms in the mental health space, suggesting that the framework effectively identifies key strengths and gaps in AI-driven mental health tools, particularly in areas such as credibility, user experience, and acute crisis management. The results also highlight the need for stringent standards to guide AI integration into mental health care in a manner that is not only effective but also safe and protective of the users' rights and welfare.

随着人工智能(AI)技术在精神和心理治疗领域发挥越来越大的作用,并成为越来越多研究关注、行业投资和公众监督的对象,评估其临床、伦理和以用户为中心的标准的工具变得至关重要。在本文中,我们首先回顾了用于评估人工智能心理健康干预的评级系统的历史。然后,我们介绍了最近推出的人工智能心理健康工具评估框架(FAITA-Mental Health),该框架的评分系统允许用户在关键领域对人工智能心理健康平台进行评分,包括可信度、用户体验、危机管理、用户代理、健康公平和透明度。最后,我们将 FAITA 心理健康量表系统地应用于 OCD Coach,展示了它的用途。OCD Coach 是一款生成式人工智能工具,可在 ChatGPT 商店中随时下载,旨在帮助控制强迫症症状。当 FAITA-Mental Health 应用于心理健康领域的 "真实世界 "生成式人工智能平台时,其结果为 FAITA-Mental Health 的实用性和局限性提供了见解,表明该框架能有效识别人工智能驱动的心理健康工具的关键优势和不足,尤其是在可信度、用户体验和急性危机管理等方面。研究结果还强调,有必要制定严格的标准,以指导人工智能与心理健康护理的整合,使其不仅有效,而且安全,并能保护用户的权利和福利。
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引用次数: 0
An Evidence-Based Nurse-Led Intervention to Reduce Diabetes Distress Among Adults With Type 1 Diabetes and Diabetes Distress (REDUCE): Development of a Complex Intervention Using Qualitative Methods Informed by the Medical Research Council Framework. 一项以证据为基础、由护士主导的干预措施,旨在减少 1 型糖尿病成人患者的糖尿病困扰和糖尿病困扰(REDUCE):根据医学研究委员会的框架制定复杂的干预措施。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-18 DOI: 10.2196/58658
Vibeke Stenov, Bryan Cleal, Ingrid Willaing, Jette Normann Christensen, Christian Gaden Jensen, Julie Drotner Mouritsen, Mette Due-Christensen

Background: Diabetes distress refers to the negative emotional reaction to living with the demands of diabetes; it occurs in >40% of adults with type 1 diabetes (T1D). However, no interventions to reduce diabetes distress are specifically designed to be an integral part of diabetes care.

Objective: This study aims to modify and adapt existing evidence-based methods into a nurse-led group intervention to reduce diabetes distress among adults with T1D and moderate to severe diabetes distress.

Methods: The overall framework of this study was informed by the initial phase of the Medical Research Council's complex intervention framework that focused on undertaking intervention identification and development to guide the adaptation of the intervention. This study took place at 2 specialized diabetes centers in Denmark from November 2019 to June 2021. A total of 36 adults with T1D participated in 10 parallel workshops. A total of 12 diabetes-specialized nurses were interviewed and participated in 1 cocreation workshop; 12 multidisciplinary specialists, including psychologists, educational specialists, and researchers, participated in 4 cocreation workshops and 14 feedback meetings. Data were analyzed by applying a deductive analytic approach.

Results: The intervention included 5 biweekly 2.5-hour small group sessions involving adults with T1D and diabetes distress. Guided by a detailed step-by-step manual, the intervention was delivered by 2 trained diabetes specialist nurses. The intervention material included visual conversation tools covering seven diabetes-specific sources derived from the 28-item Type 1 Diabetes Distress Scale for measuring diabetes distress: (1) powerlessness, (2) self-management, (3) fear of hypoglycemia, (4) food and eating, (5) friends and family, (6) negative social perception, and (7) physician distress. The tools are designed to kick-start awareness and sharing of diabetes-specific challenges and strengths, individual reflections, as well as plenary and peer-to-peer discussions about strategies to manage diabetes distress, providing new perspectives on diabetes worries and strategies to overcome negative emotions. Diabetes specialist nurses expressed a need for a manual with descriptions of methods and detailed guidelines for using the tools. To deliver the intervention, nurses need increased knowledge about diabetes distress, how to support diabetes distress reduction, and training and supervision to improve skills.

Conclusions: This co-design study describes the adaptation of a complex intervention with a strong evidence base, including detailed reporting of the theoretical underpinnings and core mechanisms.

背景:糖尿病困扰是指糖尿病患者在面对生活需求时产生的负面情绪反应,40%以上的 1 型糖尿病成人患者都会出现这种情况。然而,目前还没有专门为减少糖尿病困扰而设计的干预措施,作为糖尿病护理不可或缺的一部分:修改并调整现有的循证方法,使其成为一项由护士主导的小组干预措施,以减轻中重度 1 型糖尿病成人患者的糖尿病困扰:本研究的总体框架参考了医学研究委员会复杂干预框架的初始阶段,该框架负责干预措施的确定和开发,以指导干预措施的调整。本研究于2019年11月至2021年6月在丹麦的两家糖尿病专科中心进行。共有36名1型糖尿病成人患者参加了10个平行研讨会。12名糖尿病专科护士接受了访谈并参加了一次共同创造研讨会,12名多学科专家(心理学家、教育专家和研究人员)参加了四次共同创造研讨会和14次反馈会议。采用演绎分析法对数据进行了分析:干预措施包括每两周五次、每次两个半小时的小组会议,由两名训练有素的糖尿病专科护士在详细的步骤手册指导下,为患有 1 型糖尿病和糖尿病困扰的成人提供帮助。干预材料包括可视化对话工具,涵盖从用于测量糖尿病困扰的 28 项糖尿病困扰量表中得出的七个糖尿病特定来源:1)无能为力;2)自我管理;3)害怕低血糖;4)食物和饮食;5)朋友和家人;6)负面社会认知;7)医生困扰。这些工具旨在启动对糖尿病特定挑战和优势的认识和分享、个人反思以及全体会议和同行之间的讨论,内容涉及管理糖尿病困扰的策略、提供糖尿病担忧的新视角以及克服负面情绪的策略。糖尿病专科护士表示需要一本说明方法和使用工具详细指南的手册。要实施干预措施,护士需要增加有关糖尿病困扰的知识,了解如何支持减少糖尿病困扰,并接受培训和监督以提高技能:这项共同设计研究描述了一项复杂干预措施的调整情况,该干预措施具有强大的证据基础,包括对理论基础和核心机制的详细报告:
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引用次数: 0
Fine-Tuned Bidirectional Encoder Representations From Transformers Versus ChatGPT for Text-Based Outpatient Department Recommendation: Comparative Study. 用于基于文本的门诊部推荐的微调变压器双向编码器表示法与 ChatGPT:比较研究。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-18 DOI: 10.2196/47814
Eunbeen Jo, Hakje Yoo, Jong-Ho Kim, Young-Min Kim, Sanghoun Song, Hyung Joon Joo

Background: Patients often struggle with determining which outpatient specialist to consult based on their symptoms. Natural language processing models in health care offer the potential to assist patients in making these decisions before visiting a hospital.

Objective: This study aimed to evaluate the performance of ChatGPT in recommending medical specialties for medical questions.

Methods: We used a dataset of 31,482 medical questions, each answered by doctors and labeled with the appropriate medical specialty from the health consultation board of NAVER (NAVER Corp), a major Korean portal. This dataset includes 27 distinct medical specialty labels. We compared the performance of the fine-tuned Korean Medical bidirectional encoder representations from transformers (KM-BERT) and ChatGPT models by analyzing their ability to accurately recommend medical specialties. We categorized responses from ChatGPT into those matching the 27 predefined specialties and those that did not. Both models were evaluated using performance metrics of accuracy, precision, recall, and F1-score.

Results: ChatGPT demonstrated an answer avoidance rate of 6.2% but provided accurate medical specialty recommendations with explanations that elucidated the underlying pathophysiology of the patient's symptoms. It achieved an accuracy of 0.939, precision of 0.219, recall of 0.168, and an F1-score of 0.134. In contrast, the KM-BERT model, fine-tuned for the same task, outperformed ChatGPT with an accuracy of 0.977, precision of 0.570, recall of 0.652, and an F1-score of 0.587.

Conclusions: Although ChatGPT did not surpass the fine-tuned KM-BERT model in recommending the correct medical specialties, it showcased notable advantages as a conversational artificial intelligence model. By providing detailed, contextually appropriate explanations, ChatGPT has the potential to significantly enhance patient comprehension of medical information, thereby improving the medical referral process.

背景:患者往往难以根据自己的症状决定咨询哪位门诊专家。医疗保健领域的自然语言处理模型有可能帮助患者在去医院之前做出这些决定:本研究旨在评估 ChatGPT 在为医疗问题推荐专科方面的性能:我们使用了韩国主要门户网站 NAVER(NAVER Corp)健康咨询委员会提供的 31,482 个医疗问题数据集,每个问题都由医生回答,并标注了相应的医学专业。该数据集包含 27 个不同的医学专业标签。我们比较了经过微调的韩国医学双向编码器变压器表示法(KM-BERT)和 ChatGPT 模型的性能,分析了它们准确推荐医学专业的能力。我们将 ChatGPT 的回复分为符合 27 个预定义专科的回复和不符合的回复。我们使用准确率、精确度、召回率和 F1 分数等性能指标对这两个模型进行了评估:结果:ChatGPT 的答案回避率为 6.2%,但提供了准确的医学专业建议,并解释了患者症状的潜在病理生理学。其准确率为 0.939,精确率为 0.219,召回率为 0.168,F1 分数为 0.134。相比之下,针对同一任务进行微调的 KM-BERT 模型的准确度为 0.977,精确度为 0.570,召回率为 0.652,F1 分数为 0.587,超过了 ChatGPT:虽然 ChatGPT 在推荐正确的医学专科方面没有超过经过微调的 KM-BERT 模型,但它作为会话人工智能模型展示了显著的优势。通过提供详细的、与上下文相适应的解释,ChatGPT 有可能显著提高患者对医疗信息的理解能力,从而改善医疗转诊流程。
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引用次数: 0
Evaluating User Experiences and Preferred Features of a Web-Based 24-Hour Dietary Assessment Tool: Usability Study. 评估基于网络的 24 小时饮食评估工具的用户体验和首选功能:可用性研究。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-18 DOI: 10.2196/63823
Berit Follong, Caitlin Haliburton, Sally Mackay, Maria Maiquez, Jacqueline Grey, Cliona Ni Mhurchu

Background: Intake24, a web-based 24-hour dietary recall tool developed in the United Kingdom, was adapted for use in New Zealand (Intake24-NZ) through the addition of a New Zealand food list, portion size images, and food composition database. Owing to the customizations made, a thorough evaluation of the tool's usability was required. Detailed qualitative usability studies are well suited to investigate any challenges encountered while completing a web-based 24-hour recall and provide meaningful data to inform enhancements to the tool.

Objective: This study aims to evaluate the usability of Intake24-NZ and identify improvements to enhance both the user experience and the quality of dietary intake data collected.

Methods: We used a mixed methods approach comprising two components: (1) completion of a single 24-hour dietary recall using Intake24-NZ with both screen observation recordings and collation of verbal participant feedback on their experience and (2) a survey.

Results: A total of 37 participants aged ≥11 years self-completed the dietary recall and usability survey (men and boys: 14/37, 38% and women and girls: 23/37, 62%; Māori: 10/37, 27% and non-Māori: 27/37, 73%). Although most (31/37, 84%) reported that Intake24-NZ was easy to use and navigate, data from the recorded observations and usability survey revealed challenges related to the correct use of search terms, search results obtained (eg, type and order of foods displayed), portion size estimation, and associated food prompts (eg, did you add milk to your tea?).

Conclusions: This comprehensive usability study identified challenges experienced by users in completing a dietary recall in Intake24-NZ. The results informed a series of improvements to enhance user experience and the quality of dietary data collected with Intake24-NZ, including adding new foods to the food list, optimizing the search function and ordering of search results, creating new portion size images, and providing clearer instructions to the users.

背景:Intake24 是英国开发的一款基于网络的 24 小时膳食回忆工具,通过添加新西兰食物清单、份量图片和食物成分数据库,Intake24-NZ 被改编用于新西兰(Intake24-NZ)。由于进行了定制,因此需要对该工具的可用性进行全面评估。详细的定性可用性研究非常适合调查在完成基于网络的 24 小时回忆时遇到的任何挑战,并为工具的改进提供有意义的数据:本研究旨在评估 Intake24-NZ 的可用性,并确定改进措施,以提高用户体验和所收集膳食摄入量数据的质量:我们采用了一种混合方法,包括两个部分:方法:我们采用的混合方法包括两个部分:(1) 使用 Intake24-NZ 完成单次 24 小时膳食回顾,同时进行屏幕观察记录和整理参与者对其体验的口头反馈;(2) 调查:共有 37 名年龄≥11 岁的参与者自行完成了饮食回忆和可用性调查(男性和男孩:14/37,38%;女性和女孩:23/37,62%;毛利人:10/37,27%;非毛利人:27/37,73%)。尽管大多数人(31/37,84%)表示Intake24-NZ易于使用和浏览,但观察记录和可用性调查的数据显示,在正确使用搜索词、搜索结果(例如,显示的食物类型和顺序)、份量估算以及相关食物提示(例如,您是否在茶里加了牛奶?这项全面的可用性研究发现了用户在Intake24-NZ中完成膳食回顾时遇到的挑战。研究结果提出了一系列改进措施,以提高用户体验和 Intake24-NZ 收集到的膳食数据的质量,包括在食物列表中添加新食物、优化搜索功能和搜索结果的排序、创建新的份量图片以及为用户提供更清晰的说明。
{"title":"Evaluating User Experiences and Preferred Features of a Web-Based 24-Hour Dietary Assessment Tool: Usability Study.","authors":"Berit Follong, Caitlin Haliburton, Sally Mackay, Maria Maiquez, Jacqueline Grey, Cliona Ni Mhurchu","doi":"10.2196/63823","DOIUrl":"10.2196/63823","url":null,"abstract":"<p><strong>Background: </strong>Intake24, a web-based 24-hour dietary recall tool developed in the United Kingdom, was adapted for use in New Zealand (Intake24-NZ) through the addition of a New Zealand food list, portion size images, and food composition database. Owing to the customizations made, a thorough evaluation of the tool's usability was required. Detailed qualitative usability studies are well suited to investigate any challenges encountered while completing a web-based 24-hour recall and provide meaningful data to inform enhancements to the tool.</p><p><strong>Objective: </strong>This study aims to evaluate the usability of Intake24-NZ and identify improvements to enhance both the user experience and the quality of dietary intake data collected.</p><p><strong>Methods: </strong>We used a mixed methods approach comprising two components: (1) completion of a single 24-hour dietary recall using Intake24-NZ with both screen observation recordings and collation of verbal participant feedback on their experience and (2) a survey.</p><p><strong>Results: </strong>A total of 37 participants aged ≥11 years self-completed the dietary recall and usability survey (men and boys: 14/37, 38% and women and girls: 23/37, 62%; Māori: 10/37, 27% and non-Māori: 27/37, 73%). Although most (31/37, 84%) reported that Intake24-NZ was easy to use and navigate, data from the recorded observations and usability survey revealed challenges related to the correct use of search terms, search results obtained (eg, type and order of foods displayed), portion size estimation, and associated food prompts (eg, did you add milk to your tea?).</p><p><strong>Conclusions: </strong>This comprehensive usability study identified challenges experienced by users in completing a dietary recall in Intake24-NZ. The results informed a series of improvements to enhance user experience and the quality of dietary data collected with Intake24-NZ, including adding new foods to the food list, optimizing the search function and ordering of search results, creating new portion size images, and providing clearer instructions to the users.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11530719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142466014","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
Intensive, Real-Time Data Collection of Psychological and Physiological Stress During a 96-Hour Field Training Exercise at a Senior Military College: Feasibility and Acceptability Cohort Study. 在一所高级军事学院进行的 96 小时野外训练演习中,对心理和生理压力进行密集、实时的数据收集:可行性和可接受性队列研究》。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-18 DOI: 10.2196/60925
Rachele Pojednic, Amy Welch, Margaret Thornton, Meghan Garvey, Tara Grogan, Walter Roberts, Garrett Ash

Background: Poor physical fitness, stress, and fatigue are factors impacting military readiness, national security, and economic burden for the United States Department of Defense. Improved accuracy of wearable biosensors and remote field biologic sample collection strategies could make critical contributions to understanding how physical readiness and occupational stressors result in on-the-job and environment-related injury, sleep impairments, diagnosis of mental health disorders, and reductions in performance in war-fighters.

Objective: This study aimed to evaluate the feasibility and acceptability of intensive biomarker and biometric data collection to understand physiological and psychological stress in Army Reserved Officer Training Corps cadets before, during, and after a 96-hour field training exercise (FTX).

Methods: A prospective pilot study evaluated the feasibility and acceptability of multimodal field data collection using passive drool saliva sampling, sweat sensors, accelerometry, actigraphy, and photoplethysmography. In addition, physical fitness (Army Combat Fitness Test), self-reported injury, and psychological resilience (Brief Resilience Scale) were measured.

Results: A total of 22 cadets were included. Two were lost to follow-up due to injury during FTX, for a retention rate of 91%. Assessments of performance and psychological resilience were completed for all remaining participants, resulting in 100% testing adherence. All participants provided saliva samples before the FTX, with 98% adherence at the second time point and 91% at the third. For sweat, data collection was not possible. Average daily wear time for photoplethysmography devices was good to excellent, meeting a 70% threshold with data collected for ≥80% of person-days at all time points. Of the participants who completed the FTX and 12 completed a post-FTX acceptability survey for a response rate of 60%. Overall, participant acceptance was high (≥80%) for all metrics and devices.

Conclusions: This study demonstrates that wearable biosensors and remote field biologic sample collection strategies during a military FTX have the potential to be used in higher stakes tactical environments in the future for some, but not all, of the strategies. Overall, real-time biometric and biomarker sampling is feasible and acceptable during field-based training and provides insights and strategies for future interventions on military cadet and active-duty readiness, environmental stress, and recovery.

背景:体能不足、压力和疲劳是影响军事准备、国家安全和美国国防部经济负担的因素。提高可穿戴生物传感器和远程野外生物样本采集策略的准确性,可为了解体能准备和职业压力如何导致与工作和环境相关的伤害、睡眠障碍、心理健康疾病诊断以及作战人员表现下降做出重要贡献:本研究旨在评估强化生物标志物和生物计量数据收集的可行性和可接受性,以了解陆军预备军官训练团学员在 96 小时野外训练演习(FTX)之前、期间和之后的生理和心理压力:一项前瞻性试点研究评估了使用被动唾液采样、汗液传感器、加速度计、动作计和光电血压计进行多模式野外数据收集的可行性和可接受性。此外,还测量了体能(陆军战斗体能测试)、自我报告的受伤情况和心理复原力(简易复原力量表):结果:共纳入 22 名学员。两名学员因在 FTX 期间受伤而失去随访机会,保留率为 91%。其余所有学员均完成了成绩和心理复原力评估,测试坚持率达到 100%。所有参与者都在 FTX 前提供了唾液样本,第二个时间点的坚持率为 98%,第三个时间点的坚持率为 91%。至于汗液,则无法收集数据。光敏血压计设备的平均每日佩戴时间为良好至优秀,达到了 70% 的临界值,在所有时间点收集到的数据≥80% 人天。在完成 FTX 的参与者中,有 12 人完成了 FTX 后的接受度调查,回复率为 60%。总体而言,参与者对所有指标和设备的接受度都很高(≥80%):本研究表明,军事 FTX 期间的可穿戴生物传感器和远程野外生物样本采集策略有可能在未来更高风险的战术环境中用于某些策略,但并非所有策略。总之,在野战训练中进行实时生物计量和生物标志物采样是可行的,也是可以接受的,并为今后对军事学员和现役军人的战备状态、环境压力和恢复进行干预提供了见解和策略。
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引用次数: 0
Oral Diabetes Medication Videos on Douyin: Analysis of Information Quality and User Comment Attitudes. 豆瓣网上的口服糖尿病药物视频:信息质量与用户评论态度分析。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-18 DOI: 10.2196/57720
Baolu Zhang, Surintorn Kalampakorn, Arpaporn Powwattana, Jutatip Sillabutra, Gang Liu

Background: Oral diabetes medications are important for glucose management in people with diabetes. Although there are many health-related videos on Douyin (the Chinese version of TikTok), the quality of information and the effects on user comment attitudes are unclear.

Objective: The purpose of this study was to analyze the quality of information and user comment attitudes related to oral diabetes medication videos on Douyin.

Methods: The key phrase "oral diabetes medications" was used to search Douyin on July 24, 2023, and the final samples included 138 videos. The basic information in the videos and the content of user comments were captured using Python. Each video was assigned a sentiment category based on the predominant positive, neutral, or negative attitude, as analyzed using the Weiciyun website. Two independent raters assessed the video content and information quality using the DISCERN (a tool for assessing health information quality) and PEMAT-A/V (Patient Education Materials Assessment Tool for Audiovisual Materials) instruments.

Results: Doctors were the main source of the videos (136/138, 98.6%). The overall information quality of the videos was acceptable (median 3, IQR 1). Videos on Douyin showed relatively high understandability (median 75%, IQR 16.6%) but poor actionability (median 66.7%, IQR 48%). Most content on oral diabetes medications on Douyin related to the mechanism of action (75/138, 54.3%), precautions (70/138, 50.7%), and advantages (68/138, 49.3%), with limited content on indications (19/138, 13.8%) and contraindications (14/138, 10.1%). It was found that 10.1% (14/138) of the videos contained misinformation, of which 50% (7/14) were about the method of administration. Regarding user comment attitudes, the majority of videos garnered positive comments (81/138, 58.7%), followed by neutral comments (46/138, 33.3%) and negative comments (11/138, 8%). Multinomial logistic regression revealed 2 factors influencing a positive attitude: user comment count (adjusted odds ratio [OR] 1.00, 95% CI 1.00-1.00; P=.02) and information quality of treatment choices (adjusted OR 1.49, 95% CI 1.09-2.04; P=.01).

Conclusions: Despite most videos on Douyin being posted by doctors, with generally acceptable information quality and positive user comment attitudes, some content inaccuracies and poor actionability remain. Users show more positive attitudes toward videos with high-quality information about treatment choices. This study suggests that health care providers should ensure the accuracy and actionability of video content, enhance the information quality of treatment choices of oral diabetes medications to foster positive user attitudes, help users access accurate health information, and promote medication adherence.

背景:口服糖尿病药物对糖尿病患者的血糖管理非常重要。虽然豆瓣(TikTok 的中文版)上有许多与健康相关的视频,但其信息质量和对用户评论态度的影响尚不明确:本研究旨在分析豆瓣网上与口服糖尿病药物视频相关的信息质量和用户评论态度:2023年7月24日,以 "口服糖尿病药物 "为关键词在豆瓣进行搜索,最终得到138个视频样本。使用 Python 采集了视频的基本信息和用户评论内容。通过使用微知云网站进行分析,根据正面、中立或负面态度占主导地位的情况,为每个视频分配一个情感类别。两名独立评分员使用 DISCERN(健康信息质量评估工具)和 PEMAT-A/V(视听材料患者教育材料评估工具)工具对视频内容和信息质量进行了评估:医生是视频的主要来源(136/138,98.6%)。视频的总体信息质量可以接受(中位数为 3,IQR 为 1)。豆瓣网上的视频可理解性相对较高(中位数为 75%,IQR 为 16.6%),但可操作性较差(中位数为 66.7%,IQR 为 48%)。豆瓣网上关于口服糖尿病药物的内容大多涉及作用机制(75/138,54.3%)、注意事项(70/138,50.7%)和优点(68/138,49.3%),而关于适应症(19/138,13.8%)和禁忌症(14/138,10.1%)的内容有限。调查发现,10.1%(14/138)的视频包含错误信息,其中 50%(7/14)涉及给药方法。关于用户的评论态度,大多数视频获得了正面评论(81/138,58.7%),其次是中性评论(46/138,33.3%)和负面评论(11/138,8%)。多项式逻辑回归显示了影响积极态度的两个因素:用户评论数(调整后的几率比 [OR] 1.00,95% CI 1.00-1.00;P=.02)和治疗选择的信息质量(调整后的几率比 1.49,95% CI 1.09-2.04;P=.01):尽管豆瓣网上的大多数视频都是由医生发布的,信息质量普遍可接受,用户评论态度积极,但仍存在一些内容不准确和可操作性差的问题。用户对提供高质量治疗选择信息的视频表现出更积极的态度。本研究建议,医疗服务提供者应确保视频内容的准确性和可操作性,提高口服糖尿病药物治疗选择的信息质量,以培养用户的积极态度,帮助用户获取准确的健康信息,促进用户坚持用药。
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引用次数: 0
Phenotyping Adherence Through Technology-Enabled Reports and Navigation (the PATTERN Study): Qualitative Study for Intervention Adaptation Using the Exploration, Preparation, Implementation, and Sustainment Framework. 通过技术报告和导航对坚持治疗情况进行表型分析(PATTERN 研究):使用探索、准备、实施和维持框架进行干预适应性定性研究。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-17 DOI: 10.2196/54916
Allison P Pack, Stacy C Bailey, Rachel O'Conor, Evelyn Velazquez, Guisselle Wismer, Fangyu Yeh, Laura M Curtis, Kenya Alcantara, Michael S Wolf

Background: Older adults with multiple chronic conditions (MCC) and polypharmacy often face challenges with medication adherence. Nonadherence can lead to suboptimal treatment outcomes, adverse drug events, and poor quality of life.

Objective: To facilitate medication adherence among older adults with MCC and polypharmacy in primary care, we are adapting a technology-enabled intervention previously implemented in a specialty clinic. The objective of this study was to obtain multilevel feedback to inform the adaptation of the proposed intervention (Phenotyping Adherence Through Technology-Enabled Reports and Navigation [PATTERN]).

Methods: We conducted a formative qualitative study among patients, clinicians, and clinic administrators affiliated with a large academic health center in Chicago, Illinois. Patient eligibility included being aged 65 years or older, living with MCC, and contending with polypharmacy. Eligibility criteria for clinicians and administrators included being employed by any primary care clinic affiliated with the participating health center. Individual semistructured interviews were conducted remotely by a trained member of the study team using interview guides informed by the Exploration, Preparation, Implementation, and Sustainment Framework. Thematic analysis of interview audio recordings drew from the Rapid Identification of Themes from Audio Recordings procedures.

Results: In total, we conducted 25 interviews, including 12 with clinicians and administrators, and 13 with patients. Thematic analysis revealed participants largely found the idea of technology-based medication adherence monitoring to be acceptable and appropriate for the target population in primary care, although several concerns were raised; we discuss these in detail.

Conclusions: Our medication adherence monitoring intervention, adapted from specialty care, will be implemented in primary care. Formative interviews, informed by the Exploration, Preparation, Implementation, and Sustainment Framework and conducted among patients, clinicians, and administrators, have identified intervention adaptation needs. Results from this study could inform other interventions using the patient portal with older adults.

背景:患有多种慢性疾病(MCC)和使用多种药物的老年人在坚持用药方面常常面临挑战。不坚持用药会导致治疗效果不理想、药物不良反应和生活质量低下:为了促进患有 MCC 和多种药物的老年人在初级保健过程中坚持用药,我们对以前在专科诊所实施的技术干预措施进行了调整。本研究的目的是获取多层次的反馈信息,为调整拟议的干预措施(通过技术报告和导航实现坚持用药的表型[PATTERN])提供依据:我们在伊利诺伊州芝加哥市一家大型学术健康中心的患者、临床医生和诊所管理人员中开展了一项形成性定性研究。患者的资格标准包括年龄在 65 岁或以上、患有 MCC 并同时服用多种药物。临床医生和管理人员的资格标准包括受雇于参与医疗中心的任何附属初级保健诊所。个人半结构式访谈由一名训练有素的研究小组成员通过远程方式进行,访谈采用的访谈指南参考了 "探索、准备、实施和维持框架"。访谈录音的主题分析采用了从录音中快速识别主题的程序:我们总共进行了 25 次访谈,包括 12 次与临床医生和管理人员的访谈,以及 13 次与患者的访谈。主题分析显示,参与者普遍认为以技术为基础的用药依从性监测的想法是可以接受的,而且适合初级保健的目标人群,但也提出了一些问题;我们将对这些问题进行详细讨论:结论:我们的用药依从性监测干预是从专科医疗中改编而来的,将在初级医疗中实施。根据 "探索、准备、实施和维持框架",我们对患者、临床医生和管理人员进行了形成性访谈,确定了干预措施的调整需求。这项研究的结果可为其他使用患者门户网站的老年人干预措施提供参考。
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JMIR Formative Research
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