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A French-Language Web-Based Intervention Targeting Prolonged Grief Symptoms in People Who Are Bereaved and Separated: Randomized Controlled Trial. 针对失独者长期悲伤症状的法语网络干预:随机对照试验。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-16 DOI: 10.2196/57294
Anik Debrot, Liliane Efinger, Maya Kheyar, Valentino Pomini, Laurent Berthoud
<p><strong>Background: </strong>Losing a loved one, through death or separation, counts among the most stressful life events and is detrimental to health and well-being. About 15% of people show clinically significant difficulties coping with such an event. Web-based interventions (WBIs) are effective for a variety of mental health disorders, including prolonged grief. However, no validated WBI is available in French for treating prolonged grief symptoms.</p><p><strong>Objective: </strong>This study aimed to compare the efficacy and adherence rates of 2 WBIs for prolonged grief symptoms following the loss of a loved one through death or romantic separation.</p><p><strong>Methods: </strong>LIVIA 2.0 was developed relying on theoretical and empirical findings on bereavement processes and WBIs, and is compared with LIVIA 1, which has already demonstrated its efficacy. We conducted a randomized controlled trial and provided on-demand guidance to participants. Outcomes were assessed through web-based questionnaires before the intervention, after the intervention (12 weeks later), and at follow-up (24 weeks later). Primary outcomes were grief symptoms, depressive symptoms, and well-being. Secondary outcomes were anxiety symptoms, grief coping strategies, aspects related to self-identity, and program satisfaction.</p><p><strong>Results: </strong>In total, 62 participants were randomized (intent-to-treat [ITT] sample), 29 (47%) in LIVIA 2.0 (active arm) and 33 (53%) in LIVIA 1 (control arm). The dropout rate was 40% (37/62), and 10 participants were removed due to exclusion criteria, leading to a final per-protocol sample of 27 (44%) completers who differed from noncompleters only based on reporting fewer anxiety symptoms (t<sub>60</sub>=3.03; P=.004). Participants who are separated reported more grief symptoms (t<sub>60</sub>=2.22; P=.03) and attachment anxiety (t<sub>60</sub>=2.26; P=.03), compared to participants who are bereaved. There were pre-post within-group differences for both programs in the ITT sample, with significant reductions in grief (Cohen d=-0.90), depressive symptoms (Cohen d=-0.31), and centrality of the loss (Cohen d=-0.45). The same pattern was observed in the per-protocol sample, with the exception that anxiety symptoms also significantly diminished (Cohen d=-0.45). No difference was found in efficacy between the 2 programs (all P>.33). Participants (ITT sample) reported overall high levels of program satisfaction (mean 3.18, SD 0.54; over a maximum of 4). Effect stability was confirmed at the 6-month follow-up for all outcomes, with an improvement in self-concept clarity.</p><p><strong>Conclusions: </strong>The 2 grief-related WBIs were effective in reducing grief, depressive and anxiety symptoms for participants who are bereaved or separated. The analyses did not reveal any pre-post between-group differences, suggesting that the innovations brought to LIVIA 2.0 did not significantly affect the outcome. However, caution is warran
背景:失去亲人(死亡或分离)是人生中压力最大的事件之一,对健康和幸福有害无益。约有 15%的人在应对此类事件时表现出明显的临床困难。基于网络的干预(WBIs)对包括长期悲伤在内的各种心理健康疾病都很有效。然而,目前还没有经过验证的法语 WBI 可用于治疗长期悲伤症状:本研究旨在比较两种 WBI 对因死亡或恋爱分离而失去亲人后的长期悲伤症状的疗效和坚持率:LIVIA 2.0 是根据丧亲过程和 WBI 的理论和实证研究结果开发的,并与 LIVIA 1 进行了比较,后者已经证明了其疗效。我们进行了一项随机对照试验,并为参与者提供了按需指导。结果通过干预前、干预后(12 周后)和随访时(24 周后)的网络问卷进行评估。主要结果是悲伤症状、抑郁症状和幸福感。次要结果为焦虑症状、悲伤应对策略、自我认同相关方面以及项目满意度:共有 62 名参与者接受了随机治疗(意向治疗[ITT]样本),其中 29 人(47%)参加了 LIVIA 2.0(积极治疗组),33 人(53%)参加了 LIVIA 1(对照治疗组)。辍学率为 40% (37/62),10 名参与者因排除标准而被剔除,最终按协议完成治疗的样本为 27 人 (44%),他们与未完成治疗者的区别仅在于报告的焦虑症状较少 (t60=3.03; P=.004)。与失去亲人的参与者相比,失散的参与者报告了更多的悲伤症状(t60=2.22;P=.03)和依恋焦虑(t60=2.26;P=.03)。在 ITT 样本中,两个项目都存在前后组内差异,悲伤(Cohen d=-0.90)、抑郁症状(Cohen d=-0.31)和失去亲人的中心性(Cohen d=-0.45)显著降低。除了焦虑症状也显著减轻(Cohen d=-0.45)之外,按协议样本中也观察到了相同的模式。两个方案的疗效没有差异(P>.33)。参与者(ITT 样本)对项目的总体满意度很高(平均 3.18,标准差 0.54;最多 4 次)。6个月的随访证实了所有结果的效果稳定性,自我概念清晰度有所提高:结论:这两项与悲伤相关的 WBI 能有效减轻丧亲或离异参与者的悲伤、抑郁和焦虑症状。分析没有发现任何组间前后差异,这表明 LIVIA 2.0 的创新并未对结果产生显著影响。不过,由于样本的力量有限,只能检测到中等程度的效应,因此对结果的解释需要谨慎:试验注册:ClinicalTrials.gov NCT05219760;https://clinicaltrials.gov/study/NCT05219760.International 注册报告标识符(irrid):RR2-10.2196/39026。
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引用次数: 0
Intention to Use a Mental Health App for Menopause: Health Belief Model Approach. 使用更年期心理健康应用程序的意向:健康信念模型法
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-16 DOI: 10.2196/60434
Nayra A Martin-Key, Erin L Funnell, Jiri Benacek, Benedetta Spadaro, Sabine Bahn
<p><strong>Background: </strong>Menopause presents a period of heightened vulnerability for mental health issues. Despite this, mental health screening is not consistently integrated into menopausal health care, and access to psychological interventions is limited. Digital technologies, such as web and smartphone apps, may offer a way to facilitate and improve mental health care provision throughout menopause. However, little is known about potential users' intention to use such technologies during this critical phase of life.</p><p><strong>Objective: </strong>To examine the factors that impact the intention of potential users to use a mental health app during menopause, we used the Health Belief Model (HBM), a psychological framework widely used to understand and predict individuals' health-related behaviors.</p><p><strong>Methods: </strong>An online survey was generated. Convenience sampling was used, with participants recruited via social media and email, through relevant foundations and support groups, and by word of mouth. Structural equation modeling with maximum likelihood estimation was conducted to explore whether the factor structure of the HBM is a good fit for predicting the intention to use a mental health app for menopause. A Cronbach α value of .05 was used for determining statistical significance.</p><p><strong>Results: </strong>A total of 1154 participants commenced the survey, of which 82.49% (n=952) completed at least 97% of the survey. Of these, 86.76% (n=826) expressed that their menopausal symptoms had negatively affected their mental health, and went on to answer questions regarding their experiences and interest in using a web or smartphone app for mental health symptoms related to menopause. Data from this subgroup (N=826) were analyzed. In total, 74.09% (n=612) of respondents sought online help for mental health symptoms related to menopause. The most common topics searched for were symptom characteristics (n=435, 52.66%) and treatment or therapy options (n=210, 25.42%). Psychoeducation (n=514, 62.23%) was the most desired mental health app feature, followed by symptom tracking (n=499, 60.41%) and self-help tips (n=469, 56.78%). In terms of the intention to use a mental health app, the Satorra-Bentler-scaled fit statistics indicated a good fit for the model (χ2278=790.44, P<.001; comparative fit index=0.933, root mean square error of approximation=0.047, standardized root mean square residual=0.056), with cues to action emerging as the most significant predictor of intention (β=.48, P<.001). This was followed by perceived barriers (β=-.25, P<.001), perceived susceptibility (β=.15, P<.001), and perceived benefits (β=.13, P<.001). Perceived severity (β=.01, P=.869) and self-efficacy (β=.03, P=.286) were not significantly associated with behavioral intention.</p><p><strong>Conclusions: </strong>This study reveals important factors that influence the intention to use a mental health app during menopause. It emphasizes the ne
背景:更年期是一个更容易出现心理健康问题的时期。尽管如此,心理健康筛查并没有始终如一地融入更年期保健中,而且获得心理干预的途径也很有限。数字技术(如网络和智能手机应用程序)可能为促进和改善整个更年期的心理保健提供了一种方法。然而,人们对潜在用户在人生的这一关键阶段使用此类技术的意向知之甚少:为了研究影响潜在用户在更年期使用心理健康应用程序的意向的因素,我们使用了健康信念模型(HBM),这是一个广泛用于理解和预测个人健康相关行为的心理学框架:方法:我们制作了一份在线调查。我们采用了便利抽样法,通过社交媒体和电子邮件、相关基金会和支持团体以及口口相传的方式招募参与者。采用最大似然估计法进行结构方程建模,以探讨HBM的因子结构是否能很好地预测更年期心理健康应用程序的使用意向。统计显著性采用 Cronbach α 值 0.05:共有 1154 名参与者开始了调查,其中 82.49% (n=952)完成了至少 97% 的调查。其中,86.76%(826 人)表示更年期症状对他们的心理健康产生了负面影响,并继续回答了有关他们使用网络或智能手机应用程序治疗与更年期相关的心理健康症状的经历和兴趣的问题。我们对这一分组(826 人)的数据进行了分析。总共有 74.09% 的受访者(人数=612)就更年期相关的心理健康症状寻求过在线帮助。最常见的搜索主题是症状特征(435 人,52.66%)和治疗或疗法选择(210 人,25.42%)。心理教育(人数=514,占 62.23%)是最需要的心理健康应用程序功能,其次是症状跟踪(人数=499,占 60.41%)和自助提示(人数=469,占 56.78%)。就使用心理健康应用程序的意向而言,Satorra-Bentler-scaled 拟合统计量表明模型拟合良好(χ2278=790.44,PC 结论:本研究揭示了影响更年期心理健康应用程序使用意向的重要因素。它强调了解决应用程序使用障碍的必要性,同时突出了可信认可和心理教育的影响。此外,该研究还强调了提高数字素养较低或资源有限的用户的可访问性的重要性。
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引用次数: 0
Overcoming Communication Barriers in Clinical Care: A Digital Translation Platform. 克服临床护理中的沟通障碍:数字翻译平台。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-16 DOI: 10.2196/63095
Victor Olsavszky, Mutaz Bazari, Taieb Ben Dai, Ana Olsavszky, Fabian Finkelmeier, Mireen Friedrich-Rust, Stefan Zeuzem, Eva Herrmann, Jan Leipe, Florian Alexander Michael, Hans von Westernhagen, Olivier Ballo
<p><strong>Background: </strong>Language barriers in healthcare can lead to misdiagnosis, inappropriate treatment, and increased medical errors. Efforts to mitigate these include using interpreters and translation tools, but these measures often fall short, particularly when cultural nuances are overlooked. Consequently, medical professionals may have to rely on their staff or patients' relatives for interpretation, compromising the quality of care.</p><p><strong>Objective: </strong>This formative pilot study aims to assess the feasibility of Translatly, a digital translation platform, in clinical practice. Specifically, the study focuses on evaluating: 1. how healthcare professionals overcome language barriers and their acceptance of an on-demand video telephony platform, 2. the feasibility of the platform during medical consultations, and 3. identifying potential challenges for future development.</p><p><strong>Methods: </strong>The study included ethnographic interviews with healthcare professionals and an observational pilot to assess the use of the Tranlatly platform in clinical practice. Translatly was developed to make real-time translation easy and accessible on both Android and iOS devices. The system's backend architecture uses Java-based services hosted on DigitalOcean. The app securely exchanges data between mobile devices and servers, with user information and call records stored in a MySQL database. An admin panel helps manage the system, and Firebase integration enables fast push notifications to ensure that healthcare professionals can connect with translators whenever they need to. The platform was piloted in a German university hospital with 170 volunteer non-professional translators, mainly medical students, supporting translation in over 20 languages, including Farsi, Dari and Arabic.</p><p><strong>Results: </strong>Ethnographic research conducted by interviewing healthcare professionals in Frankfurt am Main and other German cities revealed that current practices for overcoming language barriers often rely on family members or digital tools like Google Translate, raising concerns about accuracy and emotional distress. Respondents preferred an on-demand translation service staffed by medically experienced translators, such as medical students, who understand medical terminology and can empathize with patients. The observational pilot study recorded 39 requests for translation services, 16 (41%) of which were successfully completed. The translations covered 6 different languages and were carried out by a team of 10 translators. Most requests came from departments such as infectious diseases (5, 31.25%) and emergency (4, 25%). Challenges were identified around translator availability, with 23 (59%) of requests going unanswered, which was further evidenced by user feedback.</p><p><strong>Conclusions: </strong>The pilot study demonstrates the feasibility of the Translatly platform in real-world healthcare settings. It shows potenti
背景:医疗保健中的语言障碍会导致误诊、治疗不当和医疗失误的增加。为缓解这些问题所做的努力包括使用口译员和翻译工具,但这些措施往往达不到预期效果,尤其是当文化上的细微差别被忽视时。因此,医务人员可能不得不依赖其工作人员或患者亲属进行翻译,从而影响了医疗质量:这项形成性试点研究旨在评估数字翻译平台 Translatly 在临床实践中的可行性。具体来说,研究重点在于评估1.医疗保健专业人员如何克服语言障碍以及他们对按需视频电话平台的接受程度;2.该平台在医疗咨询过程中的可行性;3.确定未来发展的潜在挑战:研究包括对医疗保健专业人员进行人种学访谈和观察试点,以评估 Tranlatly 平台在临床实践中的使用情况。Translatly的开发目的是让安卓和iOS设备都能轻松访问实时翻译。该系统的后台架构使用基于 Java 的服务,托管在 DigitalOcean 上。应用程序在移动设备和服务器之间安全地交换数据,用户信息和通话记录存储在 MySQL 数据库中。管理面板可帮助管理系统,Firebase 集成可实现快速推送通知,确保医疗保健专业人员可随时与翻译人员联系。该平台在德国一所大学医院进行了试点,有 170 名志愿非专业翻译,主要是医学生,支持 20 多种语言的翻译,包括波斯语、达里语和阿拉伯语:通过采访美因河畔法兰克福和德国其他城市的医护人员进行的人种学研究表明,目前克服语言障碍的方法通常依赖于家庭成员或谷歌翻译等数字工具,这引起了人们对准确性和情绪困扰的担忧。受访者更喜欢由医科学生等有医学经验的翻译人员提供的按需翻译服务,他们了解医学术语并能与患者产生共鸣。观察性试点研究记录了 39 项翻译服务请求,其中 16 项(41%)成功完成。这些翻译涉及 6 种不同的语言,由 10 名翻译组成的团队完成。大多数请求来自传染病科(5 个,占 31.25%)和急诊科(4 个,占 25%)。用户反馈进一步证明了这一点:试点研究证明了 Translatly 平台在现实医疗环境中的可行性。结论:试点研究证明了 Translatly 平台在实际医疗环境中的可行性,它显示了通过解决语言障碍改善沟通和患者治疗效果的潜力。尽管具有潜力,但翻译可用性等挑战凸显了进一步开发的必要性:
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引用次数: 0
WhatsApp Versus SMS for 2-Way, Text-Based Follow-Up After Voluntary Medical Male Circumcision in South Africa: Exploration of Messaging Platform Choice. 南非男性自愿医疗包皮环切术后的双向短信随访:WhatsApp 与 SMS:探索信息平台的选择。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-16 DOI: 10.2196/62762
Isabella Fabens, Calsile Makhele, Nelson Kibiribiri Igaba, Sizwe Hlongwane, Motshana Phohole, Evelyn Waweru, Femi Oni, Madalitso Khwepeya, Maria Sardini, Khumbulani Moyo, Hannock Tweya, Mourice Barasa Wafula, Jacqueline Pienaar, Felex Ndebele, Geoffrey Setswe, Tracy Qi Dong, Caryl Feldacker
<p><strong>Background: </strong>Telehealth is growing, especially in areas where access to health facilities is difficult. We previously used 2-way texting (2wT) via SMS to improve the quality of postoperative care after voluntary medical male circumcision in South Africa. In this study, we offered males aged 15 years and older WhatsApp or SMS as their message delivery and interaction platform to explore user preferences and behaviors.</p><p><strong>Objective: </strong>The objectives of this process evaluation embedded within a larger 2wT expansion trial were to (1) explore 2wT client preferences, including client satisfaction, with WhatsApp or SMS; (2) examine response rates (participation) by SMS and WhatsApp; and (3) gather feedback from the 2wT implementation team on the WhatsApp approach.</p><p><strong>Methods: </strong>Males aged 15 years and older undergoing voluntary medical male circumcision in program sites could choose their follow-up approach, selecting 2wT via SMS or WhatsApp or routine care (in-person postoperative visits). The 2wT system provided 1-way educational messages and an open 2-way communication channel between providers and clients. We analyzed quantitative data from the 2wT database on message delivery platforms (WhatsApp vs SMS), response rates, and user behaviors using chi-square tests, z tests, and t tests. The team conducted short phone calls with WhatsApp and SMS clients about their perceptions of this 2wT platform using a short, structured interview guide. We consider informal reflections from the technical team members on the use of WhatsApp. We applied an implementation science lens using the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework to focus results on practice and policy improvement.</p><p><strong>Results: </strong>Over a 2-month period-from August to October, 2023-337 males enrolled in 2wT and were offered WhatsApp or SMS and were included in the analysis. For 2wT reach, 177 (53%) participants chose WhatsApp as their platform (P=.38). Mean client age was 30 years, and 253 (75%) participants chose English for automated messages. From quality assurance calls, almost all respondents (87/89, 98%) were happy with the way they were followed up. For effectiveness, on average for the days on which responses were requested, 58 (33%) WhatsApp clients and 44 (28%) SMS clients responded (P=.50). All 2wT team members believed WhatsApp limited the automated message content, language choices, and inclusivity as compared with the SMS-based 2wT approach.</p><p><strong>Conclusions: </strong>When presented with a choice of 2wT communication platform, clients appear evenly split between SMS and WhatsApp. However, WhatsApp requires a smartphone and data plan, potentially reducing reach at scale. Clients using both platforms responded to 2wT interactive prompts, demonstrating similar effectiveness in engaging clients in follow-up. For telehealth interventions, digital health designers should
背景:远程医疗正在不断发展,尤其是在医疗设施难以到达的地区。此前,我们曾在南非使用短信双向发短信(2wT)来提高男性包皮自愿医疗割礼术后的护理质量。在这项研究中,我们为 15 岁及以上的男性提供 WhatsApp 或短信作为信息传递和互动平台,以探索用户的偏好和行为:这项过程评估是在一项更大规模的 2wT 扩展试验中进行的,其目标是:(1)探索 2wT 客户对 WhatsApp 或短信的偏好,包括客户满意度;(2)检查短信和 WhatsApp 的响应率(参与率);以及(3)收集 2wT 实施团队对 WhatsApp 方法的反馈意见:方法:在项目地点自愿接受包皮环切术的 15 岁及以上男性可选择后续治疗方法,即通过短信或 WhatsApp 进行 2wT 治疗,或进行常规护理(术后亲诊)。2wT 系统提供单向教育信息,并在医疗服务提供者和客户之间建立了开放的双向沟通渠道。我们使用卡方检验、z 检验和 t 检验分析了 2wT 数据库中有关信息发送平台(WhatsApp 与短信)、回复率和用户行为的定量数据。团队使用简短的结构化访谈指南与 WhatsApp 和短信客户进行了简短的电话访谈,了解他们对 2wT 平台的看法。我们考虑了技术团队成员对 WhatsApp 使用情况的非正式反思。我们使用 RE-AIM(覆盖范围、有效性、采用、实施和维护)框架,从实施科学的视角来关注实践和政策改进的结果:在 2023 年 8 月至 10 月的两个月时间里,有 337 名男性参加了 2wT 计划,并获得了 WhatsApp 或短信服务,他们被纳入了分析范围。在 2wT 覆盖率方面,177 名参与者(53%)选择 WhatsApp 作为他们的平台(P=.38)。客户的平均年龄为 30 岁,253 名参与者(75%)选择英语作为自动消息的语言。从质量保证电话来看,几乎所有受访者(87/89,98%)都对他们的跟进方式表示满意。就有效性而言,在要求回复的日子里,平均有 58 名(33%)WhatsApp 客户和 44 名(28%)短信客户回复(P=.50)。与基于短信的 2wT 方式相比,所有 2wT 团队成员都认为 WhatsApp 限制了自动信息内容、语言选择和包容性:当客户可以选择 2wT 交流平台时,短信和 WhatsApp 似乎各占一半。然而,WhatsApp 需要智能手机和数据计划,可能会减少覆盖范围。使用这两种平台的客户都对 2wT 互动提示做出了回应,这表明在吸引客户参与后续活动方面,这两种方法具有相似的效果。对于远程健康干预,数字健康设计者应保留基于短信的平台,并仔细考虑增加 WhatsApp 作为客户的一个选项,使用实施科学的方法来提供证据,以指导其环境中的最佳实施方法。
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引用次数: 0
Examining the Effects of Cognitive Behavioral Therapy With a Virtual Agent on User Motivation and Improvement in Psychological Distress and Anxiety: Two-Session Experimental Study. 检验虚拟代理的认知行为疗法对用户动机以及改善心理困扰和焦虑的影响:两期实验研究
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-15 DOI: 10.2196/55234
Katja Frischholz, Hiroki Tanaka, Kazuhiro Shidara, Kazuyo Onishi, Satoshi Nakamura
<p><strong>Background: </strong>Cognitive behavioral therapy (CBT) is a valuable treatment for mood disorders and anxiety. CBT methods, such as cognitive restructuring, are employed to change automatic negative thoughts to more realistic ones.</p><p><strong>Objective: </strong>This study extends on previous research conducted by the authors, focused on the process of correcting automatic negative thoughts to realistic ones and reducing distress and anxiety via CBT with a virtual agent. It was aimed to investigate whether the previously applied virtual agent would achieve changes in automatic negative thoughts when modifications to the previous experimental paradigm are applied and when user motivation is taken into consideration. Furthermore, the potential effects of existing participant knowledge concerning CBT or automatic thoughts were explored.</p><p><strong>Methods: </strong>A single-group, 2-session experiment was conducted using a within-group design. The study recruited 35 participants from May 15, 2023, to June 2, 2023, via Inter Group Corporation, with data collection following from June 5 to June 20, 2023, at Nara Institute of Science and Technology, Japan. There were 19 male and 16 female participants (age range: 18-50 years; mean 33.66, SD 10.77 years). Participants answered multiple questionnaires covering depressive symptomatology and other cognitive variables before and after a CBT session. CBT was carried out using a virtual agent, who participants conversed with using a CBT dialogue scenario on the topic of automatic negative thoughts. Session 2 of the experiment took place 1 week after session 1. Changes in distress and state anxiety were analyzed using a Wilcoxon signed-rank test and t-test for paired samples. The relationships of motivation with cognitive changes and distress or anxiety changes were investigated via correlation analysis. Multiple linear regression was used to analyze the potential predictive qualities of previous knowledge of CBT and automatic negative thoughts regarding outcome measures.</p><p><strong>Results: </strong>Significant reductions in distress (all P<.001) and state anxiety (all P<.003) emerged throughout the first and second experimental sessions. The CBT intervention increased participants' recognition of their negative thinking and their intention to change it, namely their motivation to change it. However, no clear correlations of motivation with changes in distress or anxiety were found (all P>.04). Participants reported moderate subjective changes in their cognition, which were in part positively correlated with their motivation (all P<.007). Lastly, existing knowledge of CBT did not predict reductions in distress during the first session of the experiment (P=.02).</p><p><strong>Conclusions: </strong>CBT using a virtual agent and a CBT dialogue scenario was successful in reducing distress and anxiety when talking about automatic negative thoughts. The promotion of client motivation needs to b
背景:认知行为疗法(CBT认知行为疗法(CBT)是治疗情绪障碍和焦虑症的重要方法。认知行为疗法采用认知重组等方法,将自动消极想法转变为更现实的想法:本研究是作者先前研究的延伸,重点是通过虚拟代理的 CBT 将自动消极想法纠正为现实想法的过程,以及减少痛苦和焦虑的过程。其目的是研究在对之前的实验范式进行修改并考虑用户动机的情况下,之前应用的虚拟代理是否会实现自动消极想法的改变。此外,还探讨了参与者现有的关于心理咨询治疗或自动想法的知识可能产生的影响:采用组内设计,进行了一次单组、两课时的实验。研究于 2023 年 5 月 15 日至 2023 年 6 月 2 日通过 Inter Group Corporation 招募了 35 名参与者,并于 2023 年 6 月 5 日至 6 月 20 日在日本奈良科技大学进行了数据收集。参与者中有 19 名男性和 16 名女性(年龄范围:18-50 岁;平均 33.66 岁,标准差 10.77 岁)。参与者在接受 CBT 治疗前后回答了多份调查问卷,内容包括抑郁症状和其他认知变量。CBT 是通过一个虚拟代理进行的,参与者通过 CBT 对话场景与虚拟代理就自动消极想法这一主题进行对话。实验的第二部分在第一部分结束一周后进行。实验采用 Wilcoxon 符号秩检验和配对样本 t 检验来分析受试者的痛苦和焦虑状态的变化。通过相关分析,研究了动机与认知变化、苦恼或焦虑变化之间的关系。多元线性回归用于分析以前对 CBT 的了解和自动消极想法对结果测量的潜在预测性:苦恼显著减少(均为 P.04)。参与者报告了认知方面的适度主观变化,这些变化在一定程度上与他们的积极性呈正相关(均为 P.04):使用虚拟代理和 CBT 对话情景的 CBT 成功地减少了在谈论自动消极想法时的困扰和焦虑。在设计使用虚拟代理的 CBT 干预措施时,需要认真考虑促进客户动机的问题,并且需要对动机和结果测量之间的因果关系进行进一步的实验研究。
{"title":"Examining the Effects of Cognitive Behavioral Therapy With a Virtual Agent on User Motivation and Improvement in Psychological Distress and Anxiety: Two-Session Experimental Study.","authors":"Katja Frischholz, Hiroki Tanaka, Kazuhiro Shidara, Kazuyo Onishi, Satoshi Nakamura","doi":"10.2196/55234","DOIUrl":"10.2196/55234","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Cognitive behavioral therapy (CBT) is a valuable treatment for mood disorders and anxiety. CBT methods, such as cognitive restructuring, are employed to change automatic negative thoughts to more realistic ones.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study extends on previous research conducted by the authors, focused on the process of correcting automatic negative thoughts to realistic ones and reducing distress and anxiety via CBT with a virtual agent. It was aimed to investigate whether the previously applied virtual agent would achieve changes in automatic negative thoughts when modifications to the previous experimental paradigm are applied and when user motivation is taken into consideration. Furthermore, the potential effects of existing participant knowledge concerning CBT or automatic thoughts were explored.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A single-group, 2-session experiment was conducted using a within-group design. The study recruited 35 participants from May 15, 2023, to June 2, 2023, via Inter Group Corporation, with data collection following from June 5 to June 20, 2023, at Nara Institute of Science and Technology, Japan. There were 19 male and 16 female participants (age range: 18-50 years; mean 33.66, SD 10.77 years). Participants answered multiple questionnaires covering depressive symptomatology and other cognitive variables before and after a CBT session. CBT was carried out using a virtual agent, who participants conversed with using a CBT dialogue scenario on the topic of automatic negative thoughts. Session 2 of the experiment took place 1 week after session 1. Changes in distress and state anxiety were analyzed using a Wilcoxon signed-rank test and t-test for paired samples. The relationships of motivation with cognitive changes and distress or anxiety changes were investigated via correlation analysis. Multiple linear regression was used to analyze the potential predictive qualities of previous knowledge of CBT and automatic negative thoughts regarding outcome measures.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Significant reductions in distress (all P&lt;.001) and state anxiety (all P&lt;.003) emerged throughout the first and second experimental sessions. The CBT intervention increased participants' recognition of their negative thinking and their intention to change it, namely their motivation to change it. However, no clear correlations of motivation with changes in distress or anxiety were found (all P&gt;.04). Participants reported moderate subjective changes in their cognition, which were in part positively correlated with their motivation (all P&lt;.007). Lastly, existing knowledge of CBT did not predict reductions in distress during the first session of the experiment (P=.02).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;CBT using a virtual agent and a CBT dialogue scenario was successful in reducing distress and anxiety when talking about automatic negative thoughts. The promotion of client motivation needs to b","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142466015","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
Intervention to Improve Well-Being, Nutrition, and Physical Activity in Adults: Experimental Study. 改善成年人福祉、营养和体育活动的干预措施:实验研究。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-15 DOI: 10.2196/47251
Morghane Aubert, Céline Clavel, Christine Le Scanff, Jean-Claude Martin

Background: Mindfulness improves well-being, improves emotional regulation, reduces impulses to eat, and is linked to increased physical activity. Mindfulness interventions usually focus on 1 aspect but do not offer an approach to holistically improving lifestyle.

Objective: This study aims to address this gap by designing and evaluating a holistic mindfulness intervention.

Methods: Committing to a 12-week intervention with 2-hour sessions without knowing whether you will enjoy it can be a hindrance for someone completely unfamiliar with mindfulness. For this reason, we decided to design a mindfulness intervention with short sessions over a reduced number of weeks. The aim is to enable novices to discover different aspects of mindfulness while at the same time offering a satisfactory practice for people who are already practicing mindfulness. We designed and evaluated a web-based mindfulness intervention in 5 sessions of 5 to 10 minutes each on well-being, diet, and physical activity to support a healthier lifestyle. The first 2 sessions focus on formal mindfulness meditation to enable novices to discover mindfulness and its main principles. Then there are 2 sessions about food. The first session about food aims to develop a sense of satisfaction with the food we eat and to focus our attention on new sensations. The second session about food aims to develop the ability to resist the lure of unhealthy foods. Finally, there is a session on physical activity. The aim is to develop a particular awareness of the body during movement, to increase satisfaction with physical activity, and to develop regular exercise.

Results: In total, 32 participants completed the intervention. After the intervention, we observed decreases in negative affect, anxiety, and emotional distress, and an increase in dispositional mindfulness. There was no effect on reported healthy eating habits and physical activity habits. Few participants repeated the exercises as recommended. The majority of our participants were new to mindfulness. The majority of our participants reported being satisfied with the different sessions. A few minor difficulties were mentioned, mainly related to the environment in which the participants carried out the sessions. Only 1 session was less satisfactory for one-third of the participants. The session on resistance to unhealthy foods was formulated too strictly and the idea of banning certain foods was a hindrance for one-third of the participants. A reformulation is needed.

Conclusions: The mindfulness exercises were well accepted and promoted a state of mindfulness. It would be interesting to provide easier technical access to the exercises via a mobile app so that they can be repeated easily.

背景正念可提高幸福感、改善情绪调节、减少进食冲动,并与增加体育锻炼有关。正念干预通常只关注一个方面,但没有提供全面改善生活方式的方法:本研究旨在通过设计和评估整体正念干预来弥补这一不足:方法:对于完全不熟悉正念的人来说,在不知道自己是否喜欢的情况下接受为期 12 周、每次 2 小时的正念干预可能会是一个障碍。出于这个原因,我们决定设计一种正念干预方法,在较短的周数内进行短期训练。这样做的目的是让新手发现正念的不同方面,同时为已经在练习正念的人提供令人满意的练习。我们设计并评估了一种基于网络的正念干预方法,共分为 5 个环节,每个环节 5 到 10 分钟,内容涉及健康、饮食和体育活动,以支持更健康的生活方式。前两节课侧重于正式的正念冥想,让新手了解正念及其主要原则。然后是两节关于食物的课程。第一节关于食物的课程旨在培养我们对食物的满足感,并将注意力集中在新的感觉上。第二节关于食物的课程旨在培养抵御不健康食物诱惑的能力。最后是关于体育活动的课程。其目的是在运动过程中培养对身体的特殊意识,提高对体育活动的满意度,并培养定期锻炼的习惯:共有 32 名参与者完成了干预。干预结束后,我们观察到消极情绪、焦虑和情绪困扰有所减少,倾向性正念有所增加。对报告的健康饮食习惯和体育锻炼习惯没有影响。很少有参与者按照建议重复练习。我们的大多数参与者都是正念的新手。大多数参与者对不同的课程表示满意。但也提到了一些小困难,主要与参与者进行训练的环境有关。只有一个环节让三分之一的参与者不太满意。在 "抵制不健康食品 "这一环节中,制定得过于严格,禁止食用某些食品的想法阻碍了三分 之一的参与者。需要重新制定:正念练习得到了很好的接受,并促进了正念状态的形成。如果能通过手机应用程序提供更便捷的技术手段,以便于重复练习,那将会很有意义。
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引用次数: 0
Correction: Smartphone-Based Survey and Message Compliance in Adults Initially Unready to Quit Smoking: Secondary Analysis of a Randomized Controlled Trial. 更正:基于智能手机的调查和最初不准备戒烟的成年人的信息遵守情况:随机对照试验的二次分析。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-15 DOI: 10.2196/66599
Clayton Ulm, Sixia Chen, Brianna Fleshman, Lizbeth Benson, Darla E Kendzor, Summer Frank-Pearce, Jordan M Neil, Damon Vidrine, Irene De La Torre, Michael S Businelle

[This corrects the article DOI: 10.2196/56003.].

[此处更正了文章 DOI:10.2196/56003]。
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引用次数: 0
Usability and effectiveness of a telehealth artificial-intelligence powered platform: perspectives from patients and providers in a mixed-methods study. 远程医疗人工智能平台的可用性和有效性:一项混合方法研究中患者和医疗服务提供者的观点。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-15 DOI: 10.2196/62742
Ekta Jain, Srishti Gupta, Vandana Yadav, Stan Kachnowski
<p><strong>Background: </strong>Telemedicine has revolutionized healthcare by significantly enhancing accessibility. However, the acceptability and uptake of tele-medicine is prone to various hindering factors. Studies have shown that both patients and healthcare providers appreciate the aspect of convenience. However, healthcare providers' limited understanding of or inability to leverage the technology involved can be a barrier. With advancements in telemedicine technologies, understanding the viewpoints of patients and providers is crucial for an effective and acceptable telemedicine service. This study reports findings from a usability study of HelixVM™, a telemedicine platform that uses an Artificial Intelligence (AI)-powered triage for healthcare delivery. We discuss aspects of asynchronous medicine, healthcare accessibility, saving time, productivity, data exchange, security, privacy, AI-powered triage and quality of care.</p><p><strong>Objective: </strong>To assess the usability and effectiveness of the HelixVM marketplace platform.</p><p><strong>Methods: </strong>We recruited 102 patients and 12 providers in a mixed-methods study design involving surveys, and in-depth structured interviews with a subset of the providers only. The survey questionnaires are a modified version of the telehealth utility questionnaire. We analyzed the patient's data using descriptive statistics and factor analysis to identify latent demographic patterns. For the providers data, we used a deductive thematic analysis approach to identify key themes from the interviews and interpreted overall sentiments of the providers for negative, neutral or positive. We also calculated percentages of different responses for the providers from the surveys and interviews, where applicable.</p><p><strong>Results: </strong>Patients: Overall, 86% of patients are satisfied with HelixVM and 89% will use the services again. More than 90% of patients agreed that HelixVM improves access to healthcare, saves time and that the platform is an acceptable way to receive healthcare. Chi-square tests demonstrate statistical significance for all the survey questions (p-value <.001). Results from factor analysis show a higher propensity of female gender in middle age groups whose encounter type is fast-track, self-report medium level of tech-savviness and residing in the South regions of US rate the platform more positively. Providers: Thematic analysis identified themes of asynchronous medicine in terms of accessibility and quality of care, time and productivity, integration within the workflow, data exchange and AI-triage. Certain challenges of incomplete data in patient chart and its impact on provider time are cited. Suggestions for improvements include options to ensure completeness of patient questionnaires and better screening to ensure that only asynchronous 'qualified' patients get through to the provider.</p><p><strong>Conclusions: </strong>Overall, our study findings indicate a posi
背景:远程医疗大大提高了医疗服务的可及性,从而彻底改变了医疗服务。然而,远程医疗的可接受性和使用率容易受到各种因素的阻碍。研究表明,患者和医疗服务提供者都对远程医疗的便利性表示赞赏。然而,医疗服务提供者对相关技术的了解有限或无法利用这些技术可能会成为障碍。随着远程医疗技术的发展,了解患者和医疗服务提供者的观点对于提供有效、可接受的远程医疗服务至关重要。本研究报告了对 HelixVM™ 的可用性研究结果,HelixVM™ 是一个远程医疗平台,使用人工智能(AI)驱动的分诊技术提供医疗服务。我们讨论了异步医疗、医疗可及性、节省时间、生产率、数据交换、安全性、隐私、人工智能驱动的分诊和医疗质量等方面的问题:评估 HelixVM 市场平台的可用性和有效性:我们采用混合方法研究设计,招募了 102 名患者和 12 名医疗服务提供者,其中包括调查问卷和对部分医疗服务提供者的深入结构性访谈。调查问卷是远程医疗效用问卷的修订版。我们使用描述性统计和因素分析法对患者数据进行了分析,以确定潜在的人口统计模式。对于医疗服务提供者的数据,我们采用了演绎式主题分析方法,从访谈中找出关键主题,并将医疗服务提供者的总体情绪解释为负面、中性或正面。我们还酌情计算了调查和访谈中医疗服务提供者不同回答的百分比:患者:总体而言,86% 的患者对 HelixVM 表示满意,89% 的患者将再次使用该服务。超过 90% 的患者认为 HelixVM 提高了医疗服务的可及性,节省了时间,并且该平台是一种可接受的医疗服务方式。卡方检验表明,所有调查问题均具有统计学意义(P 值结论):总体而言,我们的研究结果表明,患者和医疗服务提供者都获得了积极的体验。与传统远程医疗相比,快速处方的使用是有利的。在数据完整性、差距和准确性方面存在一些问题。研究提出了改进建议。本研究补充了现有文献的知识库,并对远程医疗市场平台的实际实施情况进行了详细分析:
{"title":"Usability and effectiveness of a telehealth artificial-intelligence powered platform: perspectives from patients and providers in a mixed-methods study.","authors":"Ekta Jain, Srishti Gupta, Vandana Yadav, Stan Kachnowski","doi":"10.2196/62742","DOIUrl":"https://doi.org/10.2196/62742","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Telemedicine has revolutionized healthcare by significantly enhancing accessibility. However, the acceptability and uptake of tele-medicine is prone to various hindering factors. Studies have shown that both patients and healthcare providers appreciate the aspect of convenience. However, healthcare providers' limited understanding of or inability to leverage the technology involved can be a barrier. With advancements in telemedicine technologies, understanding the viewpoints of patients and providers is crucial for an effective and acceptable telemedicine service. This study reports findings from a usability study of HelixVM™, a telemedicine platform that uses an Artificial Intelligence (AI)-powered triage for healthcare delivery. We discuss aspects of asynchronous medicine, healthcare accessibility, saving time, productivity, data exchange, security, privacy, AI-powered triage and quality of care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To assess the usability and effectiveness of the HelixVM marketplace platform.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We recruited 102 patients and 12 providers in a mixed-methods study design involving surveys, and in-depth structured interviews with a subset of the providers only. The survey questionnaires are a modified version of the telehealth utility questionnaire. We analyzed the patient's data using descriptive statistics and factor analysis to identify latent demographic patterns. For the providers data, we used a deductive thematic analysis approach to identify key themes from the interviews and interpreted overall sentiments of the providers for negative, neutral or positive. We also calculated percentages of different responses for the providers from the surveys and interviews, where applicable.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Patients: Overall, 86% of patients are satisfied with HelixVM and 89% will use the services again. More than 90% of patients agreed that HelixVM improves access to healthcare, saves time and that the platform is an acceptable way to receive healthcare. Chi-square tests demonstrate statistical significance for all the survey questions (p-value &lt;.001). Results from factor analysis show a higher propensity of female gender in middle age groups whose encounter type is fast-track, self-report medium level of tech-savviness and residing in the South regions of US rate the platform more positively. Providers: Thematic analysis identified themes of asynchronous medicine in terms of accessibility and quality of care, time and productivity, integration within the workflow, data exchange and AI-triage. Certain challenges of incomplete data in patient chart and its impact on provider time are cited. Suggestions for improvements include options to ensure completeness of patient questionnaires and better screening to ensure that only asynchronous 'qualified' patients get through to the provider.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Overall, our study findings indicate a posi","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Feasibility and Acceptability of a Family-Based Telehealth Intervention for Families Impacted by the Child Welfare System: Formative Mixed Methods Evaluation. 为受儿童福利制度影响的家庭提供基于家庭的远程保健干预的可行性和可接受性:形成性混合方法评估。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-15 DOI: 10.2196/57939
Johanna B Folk, Cynthia Valencia-Ayala, Evan D Holloway, Sarah Anvar, Alison Czopp, Marina Tolou-Shams
<p><strong>Background: </strong>Despite elevated rates of trauma exposure, substance misuse, mental health problems, and suicide, systems-impacted teens and their caregivers have limited access to empirically supported behavioral health services. Family-based interventions are the most effective for improving mental health, education, substance use, and delinquency outcomes, yet the familial and placement disruption that occurs during child welfare involvement can interfere with the delivery of family-based interventions.</p><p><strong>Objective: </strong>To address this gap in access to services, we adapted an in-person, empirically supported, family-based affect management intervention using a trauma-informed lens to be delivered via telehealth to families impacted by the child welfare system (Family Telehealth Project). We describe the intervention adaptation process and an open trial to evaluate its feasibility, acceptability, and impact.</p><p><strong>Methods: </strong>Adaptations to the in-person, family-based affect management intervention were conducted iteratively with input from youth, caregivers, and systems partners. Through focus groups and collaborative meetings with systems partners, a caregiver-only version of the intervention was also developed. An open trial of the intervention was conducted to assess family perspectives of its acceptability and feasibility and inform further refinements prior to a larger-scale evaluation. Participants included English-speaking families involved in the child welfare system in the past 12 months with teens (aged 12-18 years). Caregivers were eligible to participate either individually (caregivers of origin, kinship caregivers, or foster parents; n=7) or with their teen (caregiver of origin only; n=6 dyads). Participants completed session feedback forms and surveys at pretreatment, posttreatment, and 3-month posttreatment time points. Qualitative exit interviews were conducted with a subset of participants (12/19, 63%) to further understand their experiences with the intervention.</p><p><strong>Results: </strong>Session attendance was high, and both caregivers and teens reported high acceptability of clinicians and sessions on feedback forms. Families were comfortable with video technology, with very few (<5%) sessions having reported technology problems. Thematic analysis of exit interview transcripts indicated that families used effective communication and affect management skills taught during the intervention. Regarding challenges and barriers, some caregiver-only participants expressed a desire to have their teen also participate in the intervention. All interview participants reported that they would recommend the intervention to others and perceptions of the intervention were overwhelmingly positive. Quantitative surveys revealed differential responses to the intervention regarding affect management and communication.</p><p><strong>Conclusions: </strong>An open trial of the Family Telehealt
背景:尽管遭受创伤、药物滥用、精神健康问题和自杀的比例较高,但受系统影响的青少年及其照顾者获得经验支持的行为健康服务的机会有限。以家庭为基础的干预措施对改善心理健康、教育、药物使用和犯罪结果最为有效,但在儿童福利过程中出现的家庭和安置中断会干扰以家庭为基础的干预措施的实施:为了解决这一服务缺口,我们采用创伤知情视角,对基于家庭的情绪管理干预进行了改编,通过远程医疗向受儿童福利系统影响的家庭提供服务(家庭远程医疗项目)。我们介绍了干预的调整过程和一项公开试验,以评估其可行性、可接受性和影响:方法:根据青少年、照顾者和系统合作伙伴的意见,对基于家庭的面对面情绪管理干预进行了反复调整。通过焦点小组和与系统合作伙伴的合作会议,还开发了一个仅有照顾者参与的干预版本。对干预措施进行了一次公开试验,以评估家庭对其可接受性和可行性的看法,并在进行更大规模的评估之前为进一步的改进提供信息。参与者包括在过去 12 个月中与青少年(12-18 岁)一起卷入儿童福利系统的讲英语的家庭。照顾者有资格单独参加(原籍照顾者、亲属照顾者或养父母;人数=7)或与青少年一起参加(仅原籍照顾者;人数=6)。参与者在治疗前、治疗后和治疗后 3 个月的时间点填写治疗反馈表和调查表。对部分参与者(12/19,63%)进行了退出定性访谈,以进一步了解他们的干预体验:会议出席率很高,护理人员和青少年在反馈表上都表示对临床医生和会议的接受度很高。家庭对视频技术感到满意,只有极少数家庭(结论:家庭远程医疗的开放性试验结果表明,家庭对视频技术的接受程度很高:家庭远程保健项目是一项针对受儿童福利制度影响的家庭的以技能为基础的远程保健干预措施,其公开试验表明,该干预措施具有很高的可行性和可接受性。参与者注意到,在通常受创伤和家庭分离影响的领域,即沟通和情绪管理领域,干预效果有所改善。青少年和照顾者对干预措施的总体看法是积极的。家庭远程保健项目表明,该项目有望解决受系统影响家庭在行为健康获取方面的差距:试验注册:ClinicalTrials.gov NCT04488523;https://clinicaltrials.gov/study/NCT04488523。
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引用次数: 0
Perceptions of the Use of Mobile Technologies for Smoking Cessation: Focus Group Study With Individuals of Low Socioeconomic Status Who Smoke. 对使用移动技术戒烟的看法:针对社会经济地位较低的吸烟者的焦点小组研究。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-11 DOI: 10.2196/58221
Michael Wakeman, Lydia Tesfaye, Tim Gregory, Erin Leahy, Brandon Kendrick, Sherine El-Toukhy

Background: The use of mobile technologies to deliver behavioral health interventions, including smoking cessation support, has grown. Users' perceptions are important determinants of the adoption and use of new technologies. However, little is known about users' perceptions of mobile technologies as smoking cessation aids, particularly among disadvantaged individuals who smoke.

Objective: This study aimed to examine the acceptance of mobile technologies for smoking cessation among young adults with low socioeconomic status who smoke.

Methods: In total, 38 current cigarette smokers, 18 to 29 years old, who wanted to quit and did not have a 4-year college degree nor were enrolled in a 4-year college, participated in 12 semistructured digital focus groups. The moderation guide was guided by the Unified Theory of Acceptance and Use of Technology. Discussions were audio recorded, transcribed verbatim, and coded for the Unified Theory of Acceptance and Use of Technology constructs (ie, effort expectancy, facilitating conditions, performance expectancy, and social influence), sentiment (ie, negative, neutral, and positive), and purpose of using mobile technologies (ie, lifestyle and health management and smoking cessation) following a deductive thematic analysis approach.

Results: Participants had positive experiences using mobile technologies for lifestyle and health management, primarily for fitness and dietary purposes. Salient themes were facilitating conditions of use (44/80, 55%), with prior experiences and costs subthemes, followed by perceived usefulness of mobile technologies in helping users attain health goals (22/80, 27.50%), which were generally positive. Ease of use (11/80, 13.75%) and social influences (3/80, 3.75%) were minimally discussed. Conversely, participants had limited awareness of smoking cessation uses of mobile technologies, which was the primary barrier under facilitating conditions discussed (33/51, 64.70%). Participants expressed skepticism about the usefulness of mobile technologies in helping them quit smoking (14/51, 27.45%). Effort expectancy was not discussed, given participants' limited prior use. Social influences on mobile technology use for smoking cessation were minimally discussed (4/51, 7.84%).

Conclusions: The use of mobile technologies for smoking cessation was unknown to young adults with low socioeconomic status who smoke. To reduce cigarette smoking and associated health disparities, increasing awareness and use of evidence-based mobile-based smoking cessation interventions are needed. Smoking cessation interventions should incorporate features perceived as useful and easy to use to capitalize on positive user experiences and the acceptability of mobile technologies for lifestyle and health management.

背景:使用移动技术提供行为健康干预(包括戒烟支持)的情况越来越多。用户的看法是采用和使用新技术的重要决定因素。然而,人们对移动技术作为戒烟辅助工具的看法却知之甚少,尤其是在吸烟的弱势群体中:本研究旨在考察社会经济地位较低的年轻吸烟者对戒烟移动技术的接受程度:共有 38 名年龄在 18 至 29 岁之间、想要戒烟且没有四年制大学文凭或没有在四年制大学就读的现有吸烟者参加了 12 个半结构化数字焦点小组。该小组以 "接受和使用技术统一理论 "为指导。对讨论进行了录音、逐字记录,并根据接受和使用技术统一理论的结构(即努力预期、便利条件、绩效预期和社会影响)、情感(即消极、中性和积极)和使用移动技术的目的(即生活方式和健康管理以及戒烟),采用演绎式主题分析方法进行了编码:结果:参与者在使用移动技术进行生活方式和健康管理(主要用于健身和饮食)方面有着积极的体验。突出的主题是便利的使用条件(44/80,55%),包括先前的经验和成本,其次是移动技术在帮助用户实现健康目标方面的实用性(22/80,27.50%),这些主题总体上是积极的。关于易用性(11/80,13.75%)和社会影响(3/80,3.75%)的讨论很少。相反,参与者对移动技术的戒烟用途认识有限,这是讨论的促进条件下的主要障碍(33/51,64.70%)。参与者对移动技术在帮助他们戒烟方面的作用表示怀疑(14/51,27.45%)。考虑到参与者之前的使用情况有限,因此没有讨论预期努力程度。关于社会对使用移动技术戒烟的影响的讨论很少(4/51,7.84%):结论:对于社会经济地位较低的年轻成人吸烟者来说,还不知道如何使用移动技术来戒烟。为了减少吸烟和相关的健康差异,需要提高对基于证据的移动戒烟干预措施的认识和使用。戒烟干预措施应包含被认为有用和易于使用的功能,以利用积极的用户体验和移动技术在生活方式和健康管理方面的可接受性。
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引用次数: 0
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