JMIR Human Factors最新文献

Background: Cognitive functional ability affects the accessibility of IT and is thus something that should be controlled for in user experience (UX) research. However, many cognitive function assessment batteries are long and complex, making them impractical for use in conventional experimental time frames. Therefore, there is a need for a short and reliable cognitive assessment that has discriminant validity for cognitive functions needed for general IT tasks. One potential candidate is the Trail Making Test (TMT).

Objective: This study investigated the usefulness of a digital TMT as a cognitive profiling tool in IT-related UX research by assessing its predictive validity on general IT task performance and exploring its discriminant validity according to discrete cognitive functions required to perform the IT task.

Methods: A digital TMT (parts A and B) named Axon was administered to 27 healthy participants, followed by administration of 5 IT tasks in the form of CAPTCHAs (Completely Automated Public Turing tests to Tell Computers and Humans Apart). The discrete cognitive functions required to perform each CAPTCHA were rated by trained evaluators. To further explain and cross-validate our results, the original TMT and 2 psychological assessments of visuomotor and short-term memory function were administered.

Results: Axon A and B were administrable in less than 5 minutes, and overall performance was significantly predictive of general IT task performance (F_5,19=6.352; P=.001; Λ=0.374). This result was driven by performance on Axon B (F_5,19=3.382; P=.02; Λ=0.529), particularly for IT tasks involving the combination of executive processing with visual object and pattern recognition. Furthermore, Axon was cross-validated with the original TMT (P_corr=.001 and P_corr=.017 for A and B, respectively) and visuomotor and short-term memory tasks.

Conclusions: The results demonstrate that variance in IT task performance among an age-homogenous neurotypical population can be related to intersubject variance in cognitive function as assessed by Axon. Although Axon's predictive validity seemed stronger for tasks involving the combination of executive function with visual object and pattern recognition, these cognitive functions are arguably relevant to the majority of IT interfaces. Considering its short administration time and remote implementability, the Axon digital TMT demonstrates the potential to be a useful cognitive profiling tool for IT-based UX research.

Background: The clinical management of type 2 diabetes mellitus (T2DM) presents a significant challenge due to the constantly evolving clinical practice guidelines and growing array of drug classes available. Evidence suggests that artificial intelligence (AI)-enabled clinical decision support systems (CDSSs) have proven to be effective in assisting clinicians with informed decision-making. Despite the merits of AI-driven CDSSs, a significant research gap exists concerning the early-stage implementation and adoption of AI-enabled CDSSs in T2DM management.

Objective: This study aimed to explore the perspectives of clinicians on the use and impact of the AI-enabled Prescription Advisory (APA) tool, developed using a multi-institution diabetes registry and implemented in specialist endocrinology clinics, and the challenges to its adoption and application.

Methods: We conducted focus group discussions using a semistructured interview guide with purposively selected endocrinologists from a tertiary hospital. The focus group discussions were audio-recorded and transcribed verbatim. Data were thematically analyzed.

Results: A total of 13 clinicians participated in 4 focus group discussions. Our findings suggest that the APA tool offered several useful features to assist clinicians in effectively managing T2DM. Specifically, clinicians viewed the AI-generated medication alterations as a good knowledge resource in supporting the clinician's decision-making on drug modifications at the point of care, particularly for patients with comorbidities. The complication risk prediction was seen as positively impacting patient care by facilitating early doctor-patient communication and initiating prompt clinical responses. However, the interpretability of the risk scores, concerns about overreliance and automation bias, and issues surrounding accountability and liability hindered the adoption of the APA tool in clinical practice.

Conclusions: Although the APA tool holds great potential as a valuable resource for improving patient care, further efforts are required to address clinicians' concerns and improve the tool's acceptance and applicability in relevant contexts.

Background: A clinical decision support system (CDSS) based on the logic and philosophy of clinical pathways is critical for managing the quality of health care and for standardizing care processes. Using such a system at a point-of-care setting is becoming more frequent these days. However, in a low-resource setting (LRS), such systems are frequently overlooked.

Objective: The purpose of the study was to evaluate the user acceptance of a CDSS in LRSs.

Methods: The CDSS evaluation was carried out at the Jimma Health Center and the Jimma Higher Two Health Center, Jimma, Ethiopia. The evaluation was based on 22 parameters organized into 6 categories: ease of use, system quality, information quality, decision changes, process changes, and user acceptance. A Mann-Whitney U test was used to investigate whether the difference between the 2 health centers was significant (2-tailed, 95% CI; α=.05). Pearson correlation and partial least squares structural equation modeling (PLS-SEM) was used to identify the relationship and factors influencing the overall acceptance of the CDSS in an LRS.

Results: On the basis of 116 antenatal care, pregnant patient care, and postnatal care cases, 73 CDSS evaluation responses were recorded. We found that the 2 health centers did not differ significantly on 16 evaluation parameters. We did, however, detect a statistically significant difference in 6 parameters (P<.05). PLS-SEM results showed that the coefficient of determination, R², of perceived user acceptance was 0.703. More precisely, the perceived ease of use (β=.015, P=.91) and information quality (β=.149, P=.25) had no positive effect on CDSS acceptance but, rather, on the system quality and perceived benefits of the CDSS, with P<.05 and β=.321 and β=.486, respectively. Furthermore, the perceived ease of use was influenced by information quality and system quality, with an R² value of 0.479, indicating that the influence of information quality on the ease of use is significant but the influence of system quality on the ease of use is not, with β=.678 (P<.05) and β=.021(P=.89), respectively. Moreover, the influence of decision changes (β=.374, P<.05) and process changes (β=.749, P<.05) both was significant on perceived benefits (R²=0.983).

Conclusions: This study concludes that users are more likely to accept and use a CDSS at the point of care when it is easy to grasp the perceived benefits and system quality in terms of health care professionals' needs. We believe that the CDSS acceptance model developed in this study reveals specific factors and variables that constitute a step toward the effective adoption and deployment of a CDSS in LRSs.

Background: Increased pre-exposure prophylaxis (PrEP) use is urgently needed to substantially decrease HIV incidence among Black sexual minority men. Low perceived risk for HIV (PRH) is a key unaddressed PrEP barrier for Black sexual minority men. Peers and smartphone apps are popular intervention tools to promote community health behaviors, but few studies have used these together in a multicomponent strategy. Therefore, we designed a multicomponent intervention called POSSIBLE that used an existing smartphone app called PrEPme (Emocha Mobile Health, Inc) and a peer change agent (PCA) to increase PRH as a gateway to PrEP.

Objective: This paper aims to describe the feasibility and preliminary impact of POSSIBLE on PRH and willingness to accept a PrEP referral among Black sexual minority men.

Methods: POSSIBLE was a theoretically guided, single-group, 2-session pilot study conducted among Black sexual minority men from Baltimore, Maryland between 2019 and 2021 (N=69). POSSIBLE integrated a PCA and the PrEPme app that allows users to self-monitor sexual risk behaviors and chat with the in-app community health worker to obtain PrEP service information. PRH was assessed using the 8-item PRH scale before and after baseline and follow-up study visits. At the end of each study visit, the PCA referred interested individuals to the community health worker to learn more about PrEP service options.

Results: The average age of participants was 32.5 (SD 8.1, range 19-62) years. In total, 55 (80%) participants were retained for follow-up at month 1. After baseline sessions, 29 (42%) participants were willing to be referred to PrEP services, 20 (69%) of those confirmed scheduled appointments with PrEP care teams. There were no statistically significant differences in PRH between baseline and follow-up visits (t₁₂₂=-1.36; P=.17).

Conclusions: We observed no statistically significant improvement in PRH between baseline and month 1. However, given the high retention rate and acceptability, POSSIBLE may be feasible to implement. Future research should test a statistically powered peer-based approach on PrEP initiation among Black sexual minority men.

Trial registration: ClinicalTrials.gov NCT04533386; https://clinicaltrials.gov/study/NCT04533386.

Background: Overdose Fatality Review (OFR) is an important public health tool for shaping overdose prevention strategies in communities. However, OFR teams review only a few cases at a time, which typically represent a small fraction of the total fatalities in their jurisdiction. Such limited review could result in a partial understanding of local overdose patterns, leading to policy recommendations that do not fully address the broader community needs.

Objective: This study explored the potential to enhance conventional OFRs with a data dashboard, incorporating visualizations of touchpoints-events that precede overdoses-to highlight prevention opportunities.

Methods: We conducted 2 focus groups and a survey of OFR experts to characterize their information needs and design a real-time dashboard that tracks and measures decedents' past interactions with services in Indiana. Experts (N=27) were engaged, yielding insights on essential data features to incorporate and providing feedback to guide the development of visualizations.

Results: The findings highlighted the importance of showing decedents' interactions with health services (emergency medical services) and the justice system (incarcerations). Emphasis was also placed on maintaining decedent anonymity, particularly in small communities, and the need for training OFR members in data interpretation. The developed dashboard summarizes key touchpoint metrics, including prevalence, interaction frequency, and time intervals between touchpoints and overdoses, with data viewable at the county and state levels. In an initial evaluation, the dashboard was well received for its comprehensive data coverage and its potential for enhancing OFR recommendations and case selection.

Conclusions: The Indiana touchpoints dashboard is the first to display real-time visualizations that link administrative and overdose mortality data across the state. This resource equips local health officials and OFRs with timely, quantitative, and spatiotemporal insights into overdose risk factors in their communities, facilitating data-driven interventions and policy changes. However, fully integrating the dashboard into OFR practices will likely require training teams in data interpretation and decision-making.

Background: The COVID-19 pandemic contributed to an increase in teleconsultation adoption in the Polish primary health care system. It is expected that in the long run, teleconsultations will successfully replace a significant part of face-to-face visits. Therefore, a significant challenge facing primary health care facilities (PHCs) is the acceptance of teleconsultations by their users, especially physicians.

Objective: This study aimed to explore physicians' acceptance of teleconsultations during the COVID-19 pandemic in Poland.

Methods: A representative survey was conducted among 361 physicians of PHCs across Poland in 2021. For the purposes of the study, we developed a modified Technology Acceptance Model (TAM) model. Based on the modified TAM, we analyzed the impact of perceived usefulness (PU), perceived ease of use (PEU), and intention to use teleconsultation (INT) on physicians' satisfaction (SAT) and quality of work (Q). The psychometric properties of the research instrument were examined using exploratory factor analysis. Finally, structural equation modeling was used for data analysis.

Results: The results indicated a generally high level of PU (mean 3.85-4.36, SD 0.87-1.18), PEU (mean 3.81-4.60, SD 0.60-1.42), INT (mean 3.87-4.22, SD 0.89-1.12), and SAT (mean 3.55-4.13, SD 0.88-1.16); the lowest rated dimension in TAM was Q (mean 3.28-3.73, SD 1.06-1.26). The most important independent variable was PU. The influence of PU on INT (estimate=0.63, critical ratio [CR]=15.84, P<.001) and of PU on SAT (estimate=0.44, CR= 9.53, P<.001) was strong. INT was also a key factor influencing SAT (estimate=0.4, CR=8.57, P<.001). A weaker relationship was noted in the effect of PEU on INT (estimate=0.17, CR=4.31, P<.001). In turn, Q was positively influenced by INT (estimate=0.179, CR=3.64, P<.001), PU (estimate=0.246, CR=4.79, P<.001), PEU (estimate=0.18, CR=4.93, P<.001), and SAT (estimate=0.357, CR=6.97, P<.001). All paths between the constructs (PU, PEU, INT, SAT, and Q) were statistically significant, which highlights the multifaceted nature of the adoption of teleconsultations among physicians.

Conclusions: Our findings provide strong empirical support for the hypothesized relationships in TAM. The findings suggest that the PU and PEU of teleconsultation have a significant impact on the intention of physicians to adopt teleconsultation. This results in an improvement in the satisfaction of Polish physicians with the use of teleconsultation and an increase in Q. The study contributes to both theory and practice by identifying important prognostic factors affecting physicians' acceptance of teleconsultation systems.

Background: Given the physical health disparities associated with mental illness, targeted lifestyle interventions are required to reduce the risk of cardiometabolic disease. Integrating physical health early in mental health treatment among young people is essential for preventing physical comorbidities, reducing health disparities, managing medication side effects, and improving overall health outcomes. Digital technology is increasingly used to promote fitness, lifestyle, and physical health among the general population. However, using these interventions to promote physical health within mental health care requires a nuanced understanding of the factors that affect their adoption and implementation.

Objective: Using a qualitative design, we explored the attitudes of mental health care professionals (MHCPs) toward digital technologies for physical health with the goal of illuminating the opportunities, development, and implementation of the effective use of digital tools for promoting healthier lifestyles in mental health care.

Methods: Semistructured interviews were conducted with MHCPs (N=13) using reflexive thematic analysis to explore their experiences and perspectives on using digital health to promote physical health in youth mental health care settings.

Results: Three overarching themes from the qualitative analysis are reported: (1) motivation will affect implementation, (2) patients' readiness and capability, and (3) reallocation of staff roles and responsibilities. The subthemes within, and supporting quotes, are described.

Conclusions: The use of digital means presents many opportunities for improving the provision of physical health interventions in mental health care settings. However, given the limited experience of many MHCPs with these technologies, formal training and additional support may improve the likelihood of implementation. Factors such as patient symptomatology, safety, and access to technology, as well as the readiness, acceptability, and capability of both MHCPs and patients to engage with digital tools, must also be considered. In addition, the potential benefits of data integration must be carefully weighed against the associated risks.

Background: A survey conducted by McKinsey & Company reported that, as of May 2022, as many as 26% of Indonesians had recently started to engage actively in physical activity, 32% undertook regular physical activity, and 9% exercised intensely. The Fourth Industrial Revolution has spurred the rapid development of mobile fitness apps (MFAs) used to track people's sports activities. However, public interest in using these apps for any length of time is still relatively low.

Objective: In this study, we aimed to determine the effect of incentives (eg, self-monitoring, social support, platform rewards, and external influence) on the use of MFAs and the moderating effect of gender on users' continuance usage intention.

Methods: The study used a mixed methods approach. Quantitative data were collected through a web-based questionnaire and qualitative data from interviews with 30 respondents. The quantitative data, collected from 379 valid responses, were processed using covariance-based structural equation modeling. The qualitative data were processed using thematic analysis. The MFAs included in this research were those used as sports or physical activity trackers, such as Apple Fitness, Strava, Nike Run Club, and Fita.

Results: The results of the data analysis show that 3 groups of incentives, namely, self-monitoring, platform rewards, and external influence (with the exception of social support), affect the perceived usefulness of these apps. Gender was also shown to moderate user behavior in relation to physical activity. The study showed that women were more likely to be motivated to exercise by social and external factors, while men paid greater attention to the tracking features of the app and to challenges and rewards.

Conclusions: This research contributes to the field of health promotion by providing guidance for MFA developers.

Background: Given the dearth of resources to support rural public health practice, the solutions in health analytics for rural equity across the northwest dashboard (SHAREdash) was created to support rural county public health departments in northwestern United States with accessible and relevant data to identify and address health disparities in their jurisdictions. To ensure the development of useful dashboards, assessment of usability should occur at multiple stages throughout the system development life cycle. SHAREdash was refined via user-centered design methods, and upon completion, it is critical to evaluate the usability of SHAREdash.

Objective: This study aims to evaluate the usability of SHAREdash based on the system development lifecycle stage 3 evaluation goals of efficiency, satisfaction, and validity.

Methods: Public health professionals from rural health departments from Washington, Idaho, Oregon, and Alaska were enrolled in the usability study from January to April 2022. The web-based evaluation consisted of 2 think-aloud tasks and a semistructured qualitative interview. Think-aloud tasks assessed efficiency and effectiveness, and the interview investigated satisfaction and overall usability. Verbatim transcripts from the tasks and interviews were analyzed using directed content analysis.

Results: Of the 9 participants, all were female and most worked at a local health department (7/9, 78%). A mean of 10.1 (SD 1.4) clicks for task 1 (could be completed in 7 clicks) and 11.4 (SD 2.0) clicks for task 2 (could be completed in 9 clicks) were recorded. For both tasks, most participants required no prompting-89% (n=8) participants for task 1 and 67% (n=6) participants for task 2, respectively. For effectiveness, all participants were able to complete each task accurately and comprehensively. Overall, the participants were highly satisfied with the dashboard with everyone remarking on the utility of using it to support their work, particularly to compare their jurisdiction to others. Finally, half of the participants stated that the ability to share the graphs from the dashboard would be "extremely useful" for their work. The only aspect of the dashboard cited as problematic is the amount of missing data that was present, which was a constraint of the data available about rural jurisdictions.

Conclusions: Think-aloud tasks showed that the SHAREdash allows users to complete tasks efficiently. Overall, participants reported being very satisfied with the dashboard and provided multiple ways they planned to use it to support their work. The main usability issue identified was the lack of available data indicating the importance of addressing the ongoing issues of missing and fragmented public health data, particularly for rural communities.