首页 > 最新文献

JMIR Human Factors最新文献

英文 中文
Using the Theoretical Domains Framework to Identify Barriers to and Enablers of Patient Telemedicine Services Use in China: Qualitative Study. 使用理论领域框架识别中国患者远程医疗服务使用的障碍和推动因素:定性研究。
IF 3 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2026-01-21 DOI: 10.2196/78457
Ke Liu, Yuting Yang, Zixuan Song, Huixian Li, Yanli Lyu, Ke Zhang, Xinxia Wu, Zheng Hou, Yipei Wang

Background: Telemedicine has rapidly expanded worldwide due to its convenience and accessibility. In China, an increasing number of hospitals have begun offering telemedicine services; however, patient utilization remains relatively low. Limited research has examined patients' behaviors during the process of adopting telemedicine services.

Objective: This study aimed to identify barriers to and enablers for patients using telemedicine services and to formulate implementation strategies.

Methods: We conducted semistructured qualitative interviews based on the Theoretical Domains Framework (TDF) to identify barriers and enablers to telemedicine utilization. Twenty-one patients who had used Peking University Third Hospital's telemedicine services were included in the interviews. Data were analyzed using NVivo 12.0 with deductive thematic analysis guided by the TDF. Moreover, a group of experts was assembled to devise potential intervention strategies.

Results: A total of 28 themes were identified, including 14 barriers and 14 enablers across 5 of the 14 TDF domains. The most frequently reported barriers were operational challenges, prolonged waiting periods from asynchronous communication, and doubts about therapeutic efficacy, whereas the most frequently mentioned enablers were the convenience of telemedicine, time conservation, and support from hospitals. On the basis of these factors, we devised 6 intervention strategies.

Conclusions: This study demonstrated that patients' utilization of telemedicine services was affected by several barriers and enablers, including system architecture and design, patient interactions using telemedicine, and external assistance. To enhance the utilization, these factors must be meticulously considered. This study also suggests strategies to enhance the utilization of telemedicine.

背景:远程医疗因其便利性和可及性在全球范围内迅速发展。在中国,越来越多的医院开始提供远程医疗服务;然而,患者的使用率仍然相对较低。有限的研究调查了患者在接受远程医疗服务过程中的行为。目的:本研究旨在找出患者使用远程医疗服务的障碍和促进因素,并制定实施策略。方法:我们基于理论领域框架(TDF)进行了半结构化定性访谈,以确定远程医疗利用的障碍和推动因素。21例使用北京大学第三医院远程医疗服务的患者纳入访谈。数据分析采用NVivo 12.0软件,在TDF的指导下进行演绎主题分析。此外,还召集了一组专家来制定可能的干预策略。结果:共确定了28个主题,包括14个TDF领域中的5个领域的14个障碍和14个促进因素。报告中最常见的障碍是操作方面的挑战、异步通信带来的长时间等待以及对治疗效果的怀疑,而最常提到的促成因素是远程医疗的便利性、节省时间和医院的支持。基于这些因素,我们设计了6种干预策略。结论:本研究表明,患者对远程医疗服务的利用受到几个障碍和推动因素的影响,包括系统架构和设计、患者使用远程医疗的互动以及外部援助。为了提高利用率,必须仔细考虑这些因素。本研究还提出了提高远程医疗利用率的策略。
{"title":"Using the Theoretical Domains Framework to Identify Barriers to and Enablers of Patient Telemedicine Services Use in China: Qualitative Study.","authors":"Ke Liu, Yuting Yang, Zixuan Song, Huixian Li, Yanli Lyu, Ke Zhang, Xinxia Wu, Zheng Hou, Yipei Wang","doi":"10.2196/78457","DOIUrl":"10.2196/78457","url":null,"abstract":"<p><strong>Background: </strong>Telemedicine has rapidly expanded worldwide due to its convenience and accessibility. In China, an increasing number of hospitals have begun offering telemedicine services; however, patient utilization remains relatively low. Limited research has examined patients' behaviors during the process of adopting telemedicine services.</p><p><strong>Objective: </strong>This study aimed to identify barriers to and enablers for patients using telemedicine services and to formulate implementation strategies.</p><p><strong>Methods: </strong>We conducted semistructured qualitative interviews based on the Theoretical Domains Framework (TDF) to identify barriers and enablers to telemedicine utilization. Twenty-one patients who had used Peking University Third Hospital's telemedicine services were included in the interviews. Data were analyzed using NVivo 12.0 with deductive thematic analysis guided by the TDF. Moreover, a group of experts was assembled to devise potential intervention strategies.</p><p><strong>Results: </strong>A total of 28 themes were identified, including 14 barriers and 14 enablers across 5 of the 14 TDF domains. The most frequently reported barriers were operational challenges, prolonged waiting periods from asynchronous communication, and doubts about therapeutic efficacy, whereas the most frequently mentioned enablers were the convenience of telemedicine, time conservation, and support from hospitals. On the basis of these factors, we devised 6 intervention strategies.</p><p><strong>Conclusions: </strong>This study demonstrated that patients' utilization of telemedicine services was affected by several barriers and enablers, including system architecture and design, patient interactions using telemedicine, and external assistance. To enhance the utilization, these factors must be meticulously considered. This study also suggests strategies to enhance the utilization of telemedicine.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e78457"},"PeriodicalIF":3.0,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12823017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146019945","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
How to Evaluate the Accuracy of Symptom Checkers and Diagnostic Decision Support Systems: Symptom Checker Accuracy Reporting Framework (SCARF). 如何评估症状检查器和诊断决策支持系统的准确性:症状检查器准确性报告框架(SCARF)。
IF 3 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2026-01-16 DOI: 10.2196/76168
Marvin Kopka, Markus A Feufel

Unlabelled: Symptom checkers are apps and websites that assist medical laypeople in diagnosing their symptoms and determining which course of action to take. When evaluating these tools, previous studies primarily used an approach introduced a decade ago that lacked any type of quality control. Numerous studies have criticized this approach, and several empirical studies have sought to improve specific aspects of evaluations. However, even after a decade, a high-quality methodological framework for standardizing the evaluation of symptom checkers is still lacking. This paper synthesizes empirical studies to outline the Symptom Checker Accuracy Reporting Framework (SCARF) and a corresponding checklist for standardizing evaluations based on representative case selection, an externally and internally valid evaluation design, and metrics that increase cross-study comparability. This approach is supported by several open access resources to facilitate implementation. Ultimately, it should enhance the quality and comparability of future evaluations of online and artificial intelligence (AI)-based symptom checkers, diagnostic decision support systems, and large language models to enable meta-analyses and help stakeholders make more informed decisions.

无标签:症状检查器是帮助非专业医疗人员诊断症状并决定采取何种行动的应用程序和网站。在评估这些工具时,以前的研究主要使用十年前引入的方法,缺乏任何类型的质量控制。许多研究批评了这种方法,一些实证研究试图改进评价的具体方面。然而,即使在十年之后,仍然缺乏一个高质量的方法框架来标准化评估症状检查者。本文综合实证研究,概述了症状检查者准确性报告框架(Symptom Checker Accuracy Reporting Framework, SCARF)和相应的清单,用于基于代表性病例选择、外部和内部有效的评估设计以及增加交叉研究可比性的指标的标准化评估。这种方法得到了一些开放访问资源的支持,以促进实现。最终,它应该提高在线和基于人工智能(AI)的症状检查器、诊断决策支持系统和大型语言模型的未来评估的质量和可比性,以实现元分析并帮助利益相关者做出更明智的决策。
{"title":"How to Evaluate the Accuracy of Symptom Checkers and Diagnostic Decision Support Systems: Symptom Checker Accuracy Reporting Framework (SCARF).","authors":"Marvin Kopka, Markus A Feufel","doi":"10.2196/76168","DOIUrl":"10.2196/76168","url":null,"abstract":"<p><strong>Unlabelled: </strong>Symptom checkers are apps and websites that assist medical laypeople in diagnosing their symptoms and determining which course of action to take. When evaluating these tools, previous studies primarily used an approach introduced a decade ago that lacked any type of quality control. Numerous studies have criticized this approach, and several empirical studies have sought to improve specific aspects of evaluations. However, even after a decade, a high-quality methodological framework for standardizing the evaluation of symptom checkers is still lacking. This paper synthesizes empirical studies to outline the Symptom Checker Accuracy Reporting Framework (SCARF) and a corresponding checklist for standardizing evaluations based on representative case selection, an externally and internally valid evaluation design, and metrics that increase cross-study comparability. This approach is supported by several open access resources to facilitate implementation. Ultimately, it should enhance the quality and comparability of future evaluations of online and artificial intelligence (AI)-based symptom checkers, diagnostic decision support systems, and large language models to enable meta-analyses and help stakeholders make more informed decisions.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e76168"},"PeriodicalIF":3.0,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12810947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145990940","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
An Internet-Delivered Intervention to Reduce LGBTQ+ Prejudice Among Romanian Teachers: Randomized Controlled Trial. 网络干预减少罗马尼亚教师对LGBTQ+的偏见:随机对照试验。
IF 3 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2026-01-16 DOI: 10.2196/63787
Nastasia Sălăgean, Ioana Maria Latu, Torill Marie Bogsnes Larsen, Andreea Bogdana Isbășoiu, Florin Alin Sava
<p><strong>Background: </strong>Discrimination can greatly impact both physical and mental health due to frequent stressors. Younger individuals, particularly those under the age of 17 years, are more adversely affected by victimization. Within the European Union, Romania exhibits poor rankings concerning LGBTQ+ (lesbian, gay, bisexual, transgender/transsexual, queer, and other minority sexual orientations and gender identities) inclusion, with large numbers of LGBTQ+ teenagers experiencing bullying due to their sexual orientation. Given that much of this discrimination and harassment occurs within schools, teachers and counselors are vital in affecting institutional change.</p><p><strong>Objective: </strong>This study aims to investigate the impact of an intervention on reducing prejudice against the LGBTQ+ community among Romanian teachers and counselors. Most prior interventions of this nature target Western, educated, industrialized, rich, and democratic populations.</p><p><strong>Methods: </strong>In this randomized controlled trial, we recruited 175 Romanian teachers via a national closed online user group and assigned them to either the experimental or control condition. Participants in the experimental condition received the intervention first and then completed the web-based outcome measures, while those in the control condition completed the measures first and then received the intervention. The intervention, designed for internet-based delivery, consisted of a 1-hour video session led by a pair of researchers. It blended educational information with testimonials of LGBTQ+ people, perspective-taking tasks, and a self-efficacy exercise. We measured LGBTQ+ prejudice (using Attitudes Toward Lesbians and Gay Men Scale, Homophobia Scale, and Attitudes Toward Homosexuals Scale), behavioral intentions, self-efficacy, perspective taking, intergroup disgust sensitivity, intergroup anxiety, empathy, factual knowledge about LGBTQ+ issues, as well as participants' feelings toward lesbian, gay, and bisexual individuals.</p><p><strong>Results: </strong>Participants in the experimental group (n=89) showed significant reductions in prejudice when using the Attitudes Toward Lesbians and Gay Men Scale (F1,173=7.22; P=.008) when compared to the control group (n=86), but not when using the other 2 attitudinal scales. We also found that the experimental group had warmer feelings (F1,173=4.40; P=.04; d=0.32), were more likely to engage in supportive behaviors (F1,173=13.96; P<.001; d=0.56), displayed more self-efficacy (F1,173=9.14; P=.001; d=0.33), had more factual knowledge (F1,173=11.98; P=.001; d=0.52), and had a higher ability to take the LGBTQ+ perspective after controlling for contact (F1,172=4.77; P=.03; d=0.28). We did not observe significant differences in terms of intergroup disgust sensitivity (F1,173=0.816; P=.37), intergroup anxiety for either positive (F1,173=.383; P=.54) or negative emotions (F1,173=0.51; P=.48), or empathy (F1,173=0.02; P=.8
背景:由于频繁的压力源,歧视会极大地影响身心健康。年轻人,特别是17岁以下的人受到受害的不利影响更大。在欧盟内部,罗马尼亚在LGBTQ+(女同性恋、男同性恋、双性恋、变性人/变性人、酷儿和其他少数性取向和性别认同)包容性方面的排名很低,大量LGBTQ+青少年因性取向而遭受欺凌。鉴于这种歧视和骚扰大多发生在学校内部,教师和辅导员在影响制度变革方面至关重要。目的:本研究旨在探讨一项干预措施对减少罗马尼亚教师和辅导员对LGBTQ+社区的偏见的影响。大多数这种性质的先前干预针对的是受过教育、工业化、富裕和民主的西方人群。方法:在这个随机对照试验中,我们通过一个全国封闭的在线用户组招募了175名罗马尼亚教师,并将他们分配到实验条件或对照条件。实验条件下的参与者先接受干预,然后完成基于网络的结果测量,而对照组的参与者先完成测量,然后接受干预。这项干预是为基于互联网的传播而设计的,包括由两位研究人员主持的一小时视频会议。它将教育信息与LGBTQ+人群的证言、换位思考任务和自我效能练习混合在一起。我们测量了LGBTQ+偏见(使用对男女同性恋态度量表、同性恋恐惧症量表和对同性恋态度量表)、行为意图、自我效能感、观点接受、群体间厌恶敏感性、群体间焦虑、同理心、关于LGBTQ+问题的事实知识,以及参与者对女同性恋、男同性恋和双性恋个体的感受。结果:实验组(n=89)在使用男女同性恋态度量表(f1173 =7.22; P= 0.008)时,与对照组(n=86)相比,偏见有显著减少,但在使用其他两种态度量表时,偏见没有显著减少。我们还发现实验组有更温暖的感觉(f1173 =4.40; P= 0.04; d=0.32),更有可能参与支持行为(f1173 =13.96; P)。结论:干预为教育工作者和高中辅导员提供了一个具有成本效益和便携的在线资源的有效性提供了初步证据,特别是在对LGBTQ+社区的负面态度突出的地区。结果表明,整合混合的认知(信息)、情感(间接接触和视角)和行为(自我效能和赋权)方法是在学校环境中产生与LGBTQ+问题相关的积极结果的有希望的干预途径。
{"title":"An Internet-Delivered Intervention to Reduce LGBTQ+ Prejudice Among Romanian Teachers: Randomized Controlled Trial.","authors":"Nastasia Sălăgean, Ioana Maria Latu, Torill Marie Bogsnes Larsen, Andreea Bogdana Isbășoiu, Florin Alin Sava","doi":"10.2196/63787","DOIUrl":"10.2196/63787","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Discrimination can greatly impact both physical and mental health due to frequent stressors. Younger individuals, particularly those under the age of 17 years, are more adversely affected by victimization. Within the European Union, Romania exhibits poor rankings concerning LGBTQ+ (lesbian, gay, bisexual, transgender/transsexual, queer, and other minority sexual orientations and gender identities) inclusion, with large numbers of LGBTQ+ teenagers experiencing bullying due to their sexual orientation. Given that much of this discrimination and harassment occurs within schools, teachers and counselors are vital in affecting institutional change.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to investigate the impact of an intervention on reducing prejudice against the LGBTQ+ community among Romanian teachers and counselors. Most prior interventions of this nature target Western, educated, industrialized, rich, and democratic populations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this randomized controlled trial, we recruited 175 Romanian teachers via a national closed online user group and assigned them to either the experimental or control condition. Participants in the experimental condition received the intervention first and then completed the web-based outcome measures, while those in the control condition completed the measures first and then received the intervention. The intervention, designed for internet-based delivery, consisted of a 1-hour video session led by a pair of researchers. It blended educational information with testimonials of LGBTQ+ people, perspective-taking tasks, and a self-efficacy exercise. We measured LGBTQ+ prejudice (using Attitudes Toward Lesbians and Gay Men Scale, Homophobia Scale, and Attitudes Toward Homosexuals Scale), behavioral intentions, self-efficacy, perspective taking, intergroup disgust sensitivity, intergroup anxiety, empathy, factual knowledge about LGBTQ+ issues, as well as participants' feelings toward lesbian, gay, and bisexual individuals.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Participants in the experimental group (n=89) showed significant reductions in prejudice when using the Attitudes Toward Lesbians and Gay Men Scale (F1,173=7.22; P=.008) when compared to the control group (n=86), but not when using the other 2 attitudinal scales. We also found that the experimental group had warmer feelings (F1,173=4.40; P=.04; d=0.32), were more likely to engage in supportive behaviors (F1,173=13.96; P&lt;.001; d=0.56), displayed more self-efficacy (F1,173=9.14; P=.001; d=0.33), had more factual knowledge (F1,173=11.98; P=.001; d=0.52), and had a higher ability to take the LGBTQ+ perspective after controlling for contact (F1,172=4.77; P=.03; d=0.28). We did not observe significant differences in terms of intergroup disgust sensitivity (F1,173=0.816; P=.37), intergroup anxiety for either positive (F1,173=.383; P=.54) or negative emotions (F1,173=0.51; P=.48), or empathy (F1,173=0.02; P=.8","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e63787"},"PeriodicalIF":3.0,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12810945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145990494","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
Privacy Fact Sheets for Mitigating Disease-Related Privacy Concerns and Facilitating Equal Access to the Electronic Health Record: Randomized Controlled Trial. 减轻与疾病相关的隐私问题和促进平等获取电子健康记录的隐私情况说明书:随机对照试验。
IF 3 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2026-01-15 DOI: 10.2196/71124
Niklas von Kalckreuth, Markus A Feufel

Background: The German electronic health record (EHR) aims to enhance patient care and reduce costs, but users often worry about data privacy and security. To mitigate disease-related privacy concerns, for instance, surrounding stigmatized diseases, we test the effect of privacy fact sheets (PFSs)-a concise but comprehensive transparency feature designed to increase users' perceived control over their data-on increasing EHR use in a simulated online study.

Objective: The study aimed to investigate whether displaying a PFS shortly before upload decisions must be made mitigates disease-related privacy concerns and makes uploads more likely.

Methods: In an online survey study, 393 German participants from the recruitment platform Prolific were asked to interact with a randomly assigned medical report that varied systematically in terms of disease-related stigma (high vs low) and time course (TC; acute vs chronic). They were then asked to decide whether to upload the report to an EHR click dummy, while we systematically varied the presentation of privacy information (PFS vs no PFS). Participants were randomly (single-blinded) assigned to one of the 2×2×2 conditions (stigma, TC, privacy information).

Results: All 393 participants were randomly assigned to one of the following groups: low, acute, no PFS (n=52, 13.2%); low, chronic, no PFS (n=45, 11.5%); high, acute, no PFS (n=46, 11.7%); high, chronic, no PFS (n=55, 14%); low, acute, PFS (n=44, 11.2%); low, chronic, PFS (n=41, 10.4%); high, acute, PFS (n=56, 14.2%); and high, chronic, PFS (n=54, 13.7%). The results show that, in general, upload behavior is negatively influenced by disease-related stigma (odds ratio [OR] 0.130; P<.001) and positively influenced when a PFS is given (OR 4.527; P<.001). This increase was particularly pronounced for stigmatized diseases (OR 5.952; P=.006), but independent of the TC of the diseases.

Conclusions: Our results demonstrate that PFSs may help to increase EHR uploads in people interacting with a realistic EHR click dummy, by mitigating privacy concerns in scenarios involving stigmatized diseases. Results further indicate that a PFS is mainly relevant and effective for people with increased privacy risk perceptions, whereas they neither benefit nor hurt others. Thus, implementing PFSs may increase the likelihood that users who perceive high privacy risks when confronted with sensitive or stigmatized health information decide to upload their data to the EHR, ultimately increasing digital health equity.

背景:德国的电子健康记录(EHR)旨在提高患者护理和降低成本,但用户经常担心数据隐私和安全。为了减轻与疾病相关的隐私问题,例如,围绕污名性疾病,我们在模拟在线研究中测试了隐私情况说明书(pfs)的效果-一种简洁但全面的透明功能,旨在增加用户对其数据的感知控制-增加电子病历的使用。目的:该研究旨在调查在上传决定之前不久显示PFS是否减轻了与疾病相关的隐私问题,并使上传更有可能。方法:在一项在线调查研究中,来自招聘平台的393名德国参与者被要求与随机分配的医疗报告互动,该报告在疾病相关的耻辱(高与低)和时间过程(TC;急性与慢性)方面系统地变化。然后他们被要求决定是否将报告上传到电子病历点击假人,而我们系统地改变了隐私信息的呈现方式(PFS与无PFS)。参与者被随机(单盲)分配到2×2×2条件之一(耻辱,TC,隐私信息)。结果:所有393名参与者被随机分为以下两组:低、急性、无PFS (n=52, 13.2%);低,慢性,无PFS (n=45, 11.5%);高,急性,无PFS (n=46, 11.7%);高,慢性,无PFS (n= 55,14 %);低急性PFS (n=44, 11.2%);低、慢性PFS (n=41, 10.4%);急性高PFS (n=56, 14.2%);高慢性PFS (n=54, 13.7%)。结果表明,总体而言,上传行为会受到与疾病相关的耻辱感的负面影响(比值比[OR] 0.130; p)。结论:我们的研究结果表明,在与真实的电子病历点击假人互动时,pfs可能有助于通过减轻涉及耻辱感疾病的场景中的隐私问题来增加人们的电子病历上传。结果进一步表明,PFS主要与隐私风险感知增加的人相关和有效,而他们既不会给他人带来好处,也不会伤害他人。因此,实施pfs可能会增加用户在面对敏感或污名化的健康信息时感受到高度隐私风险的可能性,从而决定将其数据上传到EHR,最终增加数字健康公平。
{"title":"Privacy Fact Sheets for Mitigating Disease-Related Privacy Concerns and Facilitating Equal Access to the Electronic Health Record: Randomized Controlled Trial.","authors":"Niklas von Kalckreuth, Markus A Feufel","doi":"10.2196/71124","DOIUrl":"10.2196/71124","url":null,"abstract":"<p><strong>Background: </strong>The German electronic health record (EHR) aims to enhance patient care and reduce costs, but users often worry about data privacy and security. To mitigate disease-related privacy concerns, for instance, surrounding stigmatized diseases, we test the effect of privacy fact sheets (PFSs)-a concise but comprehensive transparency feature designed to increase users' perceived control over their data-on increasing EHR use in a simulated online study.</p><p><strong>Objective: </strong>The study aimed to investigate whether displaying a PFS shortly before upload decisions must be made mitigates disease-related privacy concerns and makes uploads more likely.</p><p><strong>Methods: </strong>In an online survey study, 393 German participants from the recruitment platform Prolific were asked to interact with a randomly assigned medical report that varied systematically in terms of disease-related stigma (high vs low) and time course (TC; acute vs chronic). They were then asked to decide whether to upload the report to an EHR click dummy, while we systematically varied the presentation of privacy information (PFS vs no PFS). Participants were randomly (single-blinded) assigned to one of the 2×2×2 conditions (stigma, TC, privacy information).</p><p><strong>Results: </strong>All 393 participants were randomly assigned to one of the following groups: low, acute, no PFS (n=52, 13.2%); low, chronic, no PFS (n=45, 11.5%); high, acute, no PFS (n=46, 11.7%); high, chronic, no PFS (n=55, 14%); low, acute, PFS (n=44, 11.2%); low, chronic, PFS (n=41, 10.4%); high, acute, PFS (n=56, 14.2%); and high, chronic, PFS (n=54, 13.7%). The results show that, in general, upload behavior is negatively influenced by disease-related stigma (odds ratio [OR] 0.130; P<.001) and positively influenced when a PFS is given (OR 4.527; P<.001). This increase was particularly pronounced for stigmatized diseases (OR 5.952; P=.006), but independent of the TC of the diseases.</p><p><strong>Conclusions: </strong>Our results demonstrate that PFSs may help to increase EHR uploads in people interacting with a realistic EHR click dummy, by mitigating privacy concerns in scenarios involving stigmatized diseases. Results further indicate that a PFS is mainly relevant and effective for people with increased privacy risk perceptions, whereas they neither benefit nor hurt others. Thus, implementing PFSs may increase the likelihood that users who perceive high privacy risks when confronted with sensitive or stigmatized health information decide to upload their data to the EHR, ultimately increasing digital health equity.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e71124"},"PeriodicalIF":3.0,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12806596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145985592","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
Designing a Substance Misuse Data Dashboard for Overdose Fatality Review Teams: User-Centered Design Approach. 为过量死亡审查小组设计物质滥用数据仪表板:以用户为中心的设计方法。
IF 3 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2026-01-15 DOI: 10.2196/79407
Marie Pisani, Madeline K Oguss, Julia Dickson-Gomez, Constance Kostelac, Amy Parry, Starr Moss, Elizabeth Salisbury-Afshar, Brian Patterson, Michael Spigner, Megan Gussick, Alison Krautkramer, Timothy Gruenloh, Askar Safipour Afshar, Preeti Gupta, Anoop Mayampurath, Majid Afshar
<p><strong>Background: </strong>Overdose fatality review (OFR) is a public health process in which cases of fatal overdose are carefully reviewed to identify prevention strategies. Current OFR requires review of multiple unconnected data sources, which is a manually intensive process. The Substance Misuse Data Commons (SMDC) was created to link electronic health record data with data from local and state agencies into a single, cloud-based e-platform but does not currently have a data visualization tool.</p><p><strong>Objective: </strong>We aimed to use human factors design principles to develop a comprehensive dashboard for the SMDC that could facilitate enhanced processes to support OFR.</p><p><strong>Methods: </strong>We first surveyed OFR leaders in Wisconsin using the National Aeronautics and Space Administration-Task Load Index to understand the cognitive workload of 3 tasks: (1) analysis of population-level overdose trends, (2) selection and preparation of individual cases for review, and (3) abstraction of data from individual causes. We then conducted semistructured interviews to identify targets for workflow optimization. Next, we developed a prototype dashboard for evaluation using a synthetic dataset built with GPT-4. We subsequently performed iterative design sessions with heuristic evaluations and collected end-user feedback on the final prototype via a second round of semistructured interviews and targeted surveys, including the Unified Theory of Acceptance and Use of Technology and the Perceived Usefulness Questionnaire.</p><p><strong>Results: </strong>The National Aeronautics and Space Administration-Task Load Index revealed a moderately high mental workload with the current workflow for all 3 tasks, with mean scores of 12.60 (SD 3.31), 11.90 (SD 3.57), and 12.43 (SD 5.41) for tasks 1, 2, and 3, respectively. Interviews pointed to causes including technological challenges and a reliance on manual processes. The prototype dashboard addressed these concerns by integrating multiple data sources to generate population-level visualizations and patient-level event timelines. End users reported the potential for improved efficiency and data accessibility compared to antecedent processes. The Unified Theory of Acceptance and Use of Technology results indicated the dashboard would likely be adopted if made available, with a mean of 4.07 out of 5.00 (SD 0.65). The Perceived Usefulness Questionnaire results suggested moderate usefulness for both the aggregate and individual-level data, with means of 3.61 (SD 0.82) and 3.64 (SD 0.85) out of 5.00, respectively.</p><p><strong>Conclusions: </strong>OFR is a data-intensive process that traditionally demands substantial cognitive and manual effort, and there are multiple barriers to efficiently collecting data and presenting them for review. The dashboard offers a user-centered, informatics-based approach to streamline data aggregation and presentation, potentially enhancing the efficiency of cas
背景:过量致死审查(OFR)是一个公共卫生过程,在此过程中,对致命过量病例进行仔细审查,以确定预防策略。目前的OFR需要审查多个未连接的数据源,这是一个人工密集型的过程。物质滥用数据共享(SMDC)的创建是为了将电子健康记录数据与地方和州机构的数据链接到一个基于云的电子平台,但目前没有数据可视化工具。目的:我们旨在利用人为因素设计原则为SMDC开发一个全面的仪表板,以促进支持OFR的增强流程。方法:我们首先使用美国国家航空航天局-任务负荷指数对威斯康星州的OFR领导进行了调查,以了解3项任务的认知负荷:(1)分析人口水平的过量趋势,(2)选择和准备个案进行审查,(3)从个人原因中提取数据。然后,我们进行了半结构化访谈,以确定工作流优化的目标。接下来,我们开发了一个原型仪表板,用于使用GPT-4构建的合成数据集进行评估。随后,我们进行了启发式评估的迭代设计会议,并通过第二轮半结构化访谈和有针对性的调查(包括技术接受和使用统一理论和感知有用性问卷)收集了最终原型的最终用户反馈。结果:美国国家航空航天局-任务负荷指数显示,在当前的工作流程中,所有3个任务的心理负荷都适度高,任务1、2和3的平均得分分别为12.60 (SD 3.31)、11.90 (SD 3.57)和12.43 (SD 5.41)。采访指出,原因包括技术挑战和对手工流程的依赖。原型仪表板通过集成多个数据源来生成人口级别的可视化和患者级别的事件时间轴,从而解决了这些问题。最终用户报告了与之前的流程相比,提高效率和数据可访问性的潜力。技术接受和使用统一理论的结果表明,仪表板很可能被采用,平均为4.07分(标准差为0.65)。感知有用性问卷的结果表明,总体和个人水平的数据都有中等程度的有用性,平均值分别为3.61 (SD 0.82)和3.64 (SD 0.85)。结论:OFR是一个数据密集型的过程,传统上需要大量的认知和手工工作,并且在有效收集数据并提交审查时存在多种障碍。仪表板提供了一种以用户为中心、基于信息学的方法来简化数据聚合和表示,潜在地提高了案例审查的效率。实现一个整合和可视化不同数据源的仪表板有可能减轻OFR中的手动工作负载。最终,我们的目标是提供一个包含真实SMDC数据的最终数据仪表板,为OFR领导者提供额外的工具,帮助他们制定严格的干预措施,以减少过量死亡。
{"title":"Designing a Substance Misuse Data Dashboard for Overdose Fatality Review Teams: User-Centered Design Approach.","authors":"Marie Pisani, Madeline K Oguss, Julia Dickson-Gomez, Constance Kostelac, Amy Parry, Starr Moss, Elizabeth Salisbury-Afshar, Brian Patterson, Michael Spigner, Megan Gussick, Alison Krautkramer, Timothy Gruenloh, Askar Safipour Afshar, Preeti Gupta, Anoop Mayampurath, Majid Afshar","doi":"10.2196/79407","DOIUrl":"10.2196/79407","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Overdose fatality review (OFR) is a public health process in which cases of fatal overdose are carefully reviewed to identify prevention strategies. Current OFR requires review of multiple unconnected data sources, which is a manually intensive process. The Substance Misuse Data Commons (SMDC) was created to link electronic health record data with data from local and state agencies into a single, cloud-based e-platform but does not currently have a data visualization tool.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;We aimed to use human factors design principles to develop a comprehensive dashboard for the SMDC that could facilitate enhanced processes to support OFR.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We first surveyed OFR leaders in Wisconsin using the National Aeronautics and Space Administration-Task Load Index to understand the cognitive workload of 3 tasks: (1) analysis of population-level overdose trends, (2) selection and preparation of individual cases for review, and (3) abstraction of data from individual causes. We then conducted semistructured interviews to identify targets for workflow optimization. Next, we developed a prototype dashboard for evaluation using a synthetic dataset built with GPT-4. We subsequently performed iterative design sessions with heuristic evaluations and collected end-user feedback on the final prototype via a second round of semistructured interviews and targeted surveys, including the Unified Theory of Acceptance and Use of Technology and the Perceived Usefulness Questionnaire.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The National Aeronautics and Space Administration-Task Load Index revealed a moderately high mental workload with the current workflow for all 3 tasks, with mean scores of 12.60 (SD 3.31), 11.90 (SD 3.57), and 12.43 (SD 5.41) for tasks 1, 2, and 3, respectively. Interviews pointed to causes including technological challenges and a reliance on manual processes. The prototype dashboard addressed these concerns by integrating multiple data sources to generate population-level visualizations and patient-level event timelines. End users reported the potential for improved efficiency and data accessibility compared to antecedent processes. The Unified Theory of Acceptance and Use of Technology results indicated the dashboard would likely be adopted if made available, with a mean of 4.07 out of 5.00 (SD 0.65). The Perceived Usefulness Questionnaire results suggested moderate usefulness for both the aggregate and individual-level data, with means of 3.61 (SD 0.82) and 3.64 (SD 0.85) out of 5.00, respectively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;OFR is a data-intensive process that traditionally demands substantial cognitive and manual effort, and there are multiple barriers to efficiently collecting data and presenting them for review. The dashboard offers a user-centered, informatics-based approach to streamline data aggregation and presentation, potentially enhancing the efficiency of cas","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e79407"},"PeriodicalIF":3.0,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12806594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145985229","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
Challenges and Benefits of Virtual Reality in Home-Based Poststroke Rehabilitation: Co-Design Qualitative Study. 虚拟现实在基于家庭的脑卒中后康复中的挑战和益处:共同设计定性研究。
IF 3 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2026-01-15 DOI: 10.2196/78798
Trust Saidi, Ann Marie Hestetun-Mandrup, Nenad Pavel, Ingvild Kristina Hurum Rosseland, Kathinka Granum Selmer-Olsen, Nora Synnøve Mørk, Åse Bergheim, Minna Annika Pikkarainen

Background: Stroke often leads to persistent impairments that limit daily functioning and psychosocial well-being. Virtual reality (VR) has emerged as a promising adjunct in stroke rehabilitation, although research has largely focused on clinical outcomes, with limited attention to user involvement and the experiences of multiple stakeholders in the design process.

Objective: This study aimed to explore the challenges and benefits of co-designing and using VR to support home-based poststroke rehabilitation.

Methods: A qualitative co-design case study was applied to gain an in-depth understanding of the challenges and benefits. Rapid co-design principles were used in developing VR prototypes delivered via head-mounted displays through 3 workshops with participants with stroke, health care professionals, and VR developers from November 2023 to May 2024. A design prototype revision was done based on feedback from the workshops. Data were collected via audio-taped co-design workshops with all participants and 10 successive semistructured interviews with health care professionals and VR developers conducted in a rehabilitation hospital. A thematic analysis was performed on transcribed recordings.

Results: In total, five main themes emerged: (1) adaptability for stroke-related impairments in home rehabilitation, (2) safety and ease of use, (3) goal orientation, (4) motivation, and (5) VR as a complementary tool. One of the primary challenges identified lies in the adaptability of VR systems for individuals with hemiparesis. Additionally, customization and safety concerns remain a complex barrier, as VR solutions must be capable of addressing a wide range of stroke-related impairments and aligning specific rehabilitation goals. VR demonstrated potential to enhance rehabilitation by simulating real-life tasks that encourage goal-oriented and motivating therapy. As a complementary tool, VR can enhance traditional rehabilitation by increasing the intensity and volume of therapy.

Conclusions: This study offers insight into how VR can be effectively integrated into rehabilitation practices. Its integration into rehabilitation requires alignment with established therapeutic principles within VR applications, such as adjustable task-specific training and meaningful outcomes tailored to individual needs, to ensure clinical relevance and user engagement. VR should complement, rather than replace, conventional therapy by increasing training intensity, reducing therapist workload, and extending rehabilitation into the home. Thoughtful co-design with stakeholders is key to creating VR tools that bridge the gap between structured clinical care and independent recovery, offering continuous support throughout the rehabilitation process.

背景:中风常常导致持续的损害,限制日常功能和社会心理健康。虚拟现实(VR)已经成为中风康复中一个很有前途的辅助手段,尽管研究主要集中在临床结果上,很少关注用户参与和设计过程中多个利益相关者的体验。目的:本研究旨在探讨共同设计和使用虚拟现实技术支持脑卒中后家庭康复的挑战和益处。方法:采用定性的协同设计案例研究来深入了解挑战和收益。从2023年11月到2024年5月,通过三次研讨会,参与者包括中风患者、医疗保健专业人员和VR开发人员,快速协同设计原则被用于开发通过头戴式显示器交付的VR原型。设计原型的修改是根据研讨会的反馈完成的。通过与所有参与者的录音共同设计研讨会以及在一家康复医院与卫生保健专业人员和VR开发人员进行的10次连续半结构化访谈来收集数据。对转录的录音进行了专题分析。结果:总共出现了五个主要主题:(1)家庭康复中卒中相关损伤的适应性,(2)安全性和易用性,(3)目标定向,(4)动机,(5)VR作为补充工具。确定的主要挑战之一是VR系统对偏瘫患者的适应性。此外,定制化和安全问题仍然是一个复杂的障碍,因为VR解决方案必须能够解决广泛的中风相关损伤,并协调特定的康复目标。VR通过模拟现实生活中的任务,鼓励目标导向和激励治疗,展示了增强康复的潜力。作为一种辅助工具,VR可以通过增加治疗的强度和量来增强传统的康复。结论:这项研究为如何将VR有效地整合到康复实践中提供了见解。将其整合到康复中需要与VR应用中已建立的治疗原则保持一致,例如可调整的特定任务培训和针对个人需求量身定制的有意义的结果,以确保临床相关性和用户参与度。虚拟现实应该通过增加训练强度、减少治疗师工作量和将康复扩展到家庭来补充而不是取代传统治疗。与利益相关者进行深思熟虑的共同设计是创造VR工具的关键,这些工具可以弥合结构化临床护理和独立康复之间的差距,并在整个康复过程中提供持续的支持。
{"title":"Challenges and Benefits of Virtual Reality in Home-Based Poststroke Rehabilitation: Co-Design Qualitative Study.","authors":"Trust Saidi, Ann Marie Hestetun-Mandrup, Nenad Pavel, Ingvild Kristina Hurum Rosseland, Kathinka Granum Selmer-Olsen, Nora Synnøve Mørk, Åse Bergheim, Minna Annika Pikkarainen","doi":"10.2196/78798","DOIUrl":"10.2196/78798","url":null,"abstract":"<p><strong>Background: </strong>Stroke often leads to persistent impairments that limit daily functioning and psychosocial well-being. Virtual reality (VR) has emerged as a promising adjunct in stroke rehabilitation, although research has largely focused on clinical outcomes, with limited attention to user involvement and the experiences of multiple stakeholders in the design process.</p><p><strong>Objective: </strong>This study aimed to explore the challenges and benefits of co-designing and using VR to support home-based poststroke rehabilitation.</p><p><strong>Methods: </strong>A qualitative co-design case study was applied to gain an in-depth understanding of the challenges and benefits. Rapid co-design principles were used in developing VR prototypes delivered via head-mounted displays through 3 workshops with participants with stroke, health care professionals, and VR developers from November 2023 to May 2024. A design prototype revision was done based on feedback from the workshops. Data were collected via audio-taped co-design workshops with all participants and 10 successive semistructured interviews with health care professionals and VR developers conducted in a rehabilitation hospital. A thematic analysis was performed on transcribed recordings.</p><p><strong>Results: </strong>In total, five main themes emerged: (1) adaptability for stroke-related impairments in home rehabilitation, (2) safety and ease of use, (3) goal orientation, (4) motivation, and (5) VR as a complementary tool. One of the primary challenges identified lies in the adaptability of VR systems for individuals with hemiparesis. Additionally, customization and safety concerns remain a complex barrier, as VR solutions must be capable of addressing a wide range of stroke-related impairments and aligning specific rehabilitation goals. VR demonstrated potential to enhance rehabilitation by simulating real-life tasks that encourage goal-oriented and motivating therapy. As a complementary tool, VR can enhance traditional rehabilitation by increasing the intensity and volume of therapy.</p><p><strong>Conclusions: </strong>This study offers insight into how VR can be effectively integrated into rehabilitation practices. Its integration into rehabilitation requires alignment with established therapeutic principles within VR applications, such as adjustable task-specific training and meaningful outcomes tailored to individual needs, to ensure clinical relevance and user engagement. VR should complement, rather than replace, conventional therapy by increasing training intensity, reducing therapist workload, and extending rehabilitation into the home. Thoughtful co-design with stakeholders is key to creating VR tools that bridge the gap between structured clinical care and independent recovery, offering continuous support throughout the rehabilitation process.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e78798"},"PeriodicalIF":3.0,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12856395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145990989","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
Correction: Auxiliary Teaching and Student Evaluation Methods Based on Facial Expression Recognition in Medical Education. 修正:基于面部表情识别的医学教学辅助教学与学生评价方法。
IF 3 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2026-01-14 DOI: 10.2196/89669
Xueling Zhu, Roben A Juanatas
{"title":"Correction: Auxiliary Teaching and Student Evaluation Methods Based on Facial Expression Recognition in Medical Education.","authors":"Xueling Zhu, Roben A Juanatas","doi":"10.2196/89669","DOIUrl":"10.2196/89669","url":null,"abstract":"","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e89669"},"PeriodicalIF":3.0,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12820756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146012599","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
Long-Term Effects of Multimedia Education and "Foot Alerts" Through the MyU App on Diabetic Foot Care in Individuals With Moderate-High Risk: Pilot Randomized Controlled Trial. 通过MyU App进行多媒体教育和“足部警报”对中高危险人群糖尿病足护理的长期影响:先导随机对照试验
IF 3 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2026-01-13 DOI: 10.2196/78261
Ameenah Alawadhi, Kay Scarsbrook Khan, Grace Messenger, Alice Cusworth, Mohammad Assi, Stuart R Gray, Ebaa Al-Ozairi

Background: Diabetic foot ulceration (DFU) is the leading cause of nontraumatic amputations in people with diabetes. Research shows that improving patient awareness can result in short-term improvements, but Cochrane reviews report insufficient high-quality evidence.

Objective: This study aims to investigate the effects of multimedia presentation and smartphone alerts to enhance long-term knowledge and foot care behaviors in individuals at moderate-to-high risk of DFU.

Methods: Participants were randomized to a control group, receiving usual diabetic foot care advice (n=40), or an intervention group, receiving a multimedia diabetic foot care presentation and regular "foot alerts" through the MyU smartphone app on top of usual care (n=37). Patient's knowledge and behaviors related to diabetic foot care were assessed at baseline and after 12 months. Repeated measures ANOVA was conducted in both intention-to-treat and per-protocol analyses to evaluate the intervention's effectiveness.

Results: The findings were consistent across intention-to-treat and per-protocol analyses. In the intervention group, the number of podiatry visits was positively correlated with improved foot care behavior (r=0.408; P=.02), while the control group showed a negative correlation (r=-0.402; P=.02). No significant correlations were observed with knowledge scores. Although no significant time×group interactions were seen, the main effects of time were found for both knowledge (η²=0.12; P=.004) and behavior scores (η²=0.31; P<.001). Post hoc analysis showed a decline in knowledge scores in the control group (Cohen d=-0.24; P=.007) and improvements in behavior scores in both groups (Cohen d: intervention=0.61, control=0.63; all P<.001).

Conclusions: The MyU app-based multimedia intervention was associated with improved foot care behaviors over 12 months, indicating potential benefits as an adjunct to usual diabetic foot care. However, no significant changes in diabetic foot care knowledge were observed. These findings suggest that while the applied digital multimedia tool may support behavior change, further research is needed to enhance knowledge retention and clinical impact. The study revealed that multimedia education alone may not be effective for long-term improvement in foot self-care knowledge and behavior among individuals at moderate-high DFU risk, but the reinforcement of educational material during follow-up podiatry visits could be effective.

背景:糖尿病足溃疡(DFU)是糖尿病患者非创伤性截肢的主要原因。研究表明,提高患者的意识可以带来短期的改善,但Cochrane综述报告缺乏高质量的证据。目的:本研究旨在探讨多媒体演示和智能手机提醒对DFU中高风险个体长期知识和足部护理行为的影响。方法:参与者被随机分为对照组(n=40)和干预组(n=37),对照组接受常规糖尿病足护理建议,干预组在常规护理的基础上,通过MyU智能手机应用程序接受多媒体糖尿病足护理介绍和定期“足部警报”。在基线和12个月后评估患者与糖尿病足护理相关的知识和行为。在意向治疗和方案分析中进行重复测量方差分析,以评估干预措施的有效性。结果:意向治疗和方案分析的结果一致。干预组足部就诊次数与足部护理行为改善呈正相关(r=0.408, P= 0.02),对照组为负相关(r=-0.402, P= 0.02)。与知识得分无显著相关。虽然没有发现显著的time×group交互作用,但时间的主要影响是知识(η²=0.12;P= 0.004)和行为评分(η²=0.31)。结论:基于MyU应用程序的多媒体干预与12个月内足部护理行为的改善相关,表明作为常规糖尿病足部护理的辅助手段有潜在的益处。然而,没有观察到糖尿病足护理知识的显著变化。这些发现表明,虽然应用数字多媒体工具可能支持行为改变,但需要进一步研究以增强知识保留和临床影响。本研究显示,仅靠多媒体教育对中高足部足部疾病风险个体足部自我护理知识和行为的长期改善可能并不有效,但在后续足部就诊期间加强教育材料可能有效。
{"title":"Long-Term Effects of Multimedia Education and \"Foot Alerts\" Through the MyU App on Diabetic Foot Care in Individuals With Moderate-High Risk: Pilot Randomized Controlled Trial.","authors":"Ameenah Alawadhi, Kay Scarsbrook Khan, Grace Messenger, Alice Cusworth, Mohammad Assi, Stuart R Gray, Ebaa Al-Ozairi","doi":"10.2196/78261","DOIUrl":"10.2196/78261","url":null,"abstract":"<p><strong>Background: </strong>Diabetic foot ulceration (DFU) is the leading cause of nontraumatic amputations in people with diabetes. Research shows that improving patient awareness can result in short-term improvements, but Cochrane reviews report insufficient high-quality evidence.</p><p><strong>Objective: </strong>This study aims to investigate the effects of multimedia presentation and smartphone alerts to enhance long-term knowledge and foot care behaviors in individuals at moderate-to-high risk of DFU.</p><p><strong>Methods: </strong>Participants were randomized to a control group, receiving usual diabetic foot care advice (n=40), or an intervention group, receiving a multimedia diabetic foot care presentation and regular \"foot alerts\" through the MyU smartphone app on top of usual care (n=37). Patient's knowledge and behaviors related to diabetic foot care were assessed at baseline and after 12 months. Repeated measures ANOVA was conducted in both intention-to-treat and per-protocol analyses to evaluate the intervention's effectiveness.</p><p><strong>Results: </strong>The findings were consistent across intention-to-treat and per-protocol analyses. In the intervention group, the number of podiatry visits was positively correlated with improved foot care behavior (r=0.408; P=.02), while the control group showed a negative correlation (r=-0.402; P=.02). No significant correlations were observed with knowledge scores. Although no significant time×group interactions were seen, the main effects of time were found for both knowledge (η²=0.12; P=.004) and behavior scores (η²=0.31; P<.001). Post hoc analysis showed a decline in knowledge scores in the control group (Cohen d=-0.24; P=.007) and improvements in behavior scores in both groups (Cohen d: intervention=0.61, control=0.63; all P<.001).</p><p><strong>Conclusions: </strong>The MyU app-based multimedia intervention was associated with improved foot care behaviors over 12 months, indicating potential benefits as an adjunct to usual diabetic foot care. However, no significant changes in diabetic foot care knowledge were observed. These findings suggest that while the applied digital multimedia tool may support behavior change, further research is needed to enhance knowledge retention and clinical impact. The study revealed that multimedia education alone may not be effective for long-term improvement in foot self-care knowledge and behavior among individuals at moderate-high DFU risk, but the reinforcement of educational material during follow-up podiatry visits could be effective.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e78261"},"PeriodicalIF":3.0,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12800894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967223","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
Bridging Gaps in Women's Heart Health: User-Centered Needs Assessment Informed by Patient and Clinician Interviews. 弥合妇女心脏健康的差距:由患者和临床医生访谈提供的以用户为中心的需求评估。
IF 3 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2026-01-13 DOI: 10.2196/82916
Christine Jacob, Sangeetha-Rose Puthanveettil, Patrick Vavken, Emel Kaplan, Christine S Zuern
<p><strong>Background: </strong>Women with cardiovascular disease (CVD) remain underserved due to gaps in recognition, diagnosis, and care tailored to sex-specific risks. Digital health tools have the potential to address these inequities, but many fail to reflect the distinct needs of women. In a prior review, we assessed 20 CVD apps and 22 wearables and found that only 25% (5/20) of apps and 40% (9/22) of wearables included any sex-specific content, such as hormone cycle tracking and life-stage considerations related to pregnancy or menopause. These findings confirm that current digital tools largely mirror the gender gaps seen in traditional care.</p><p><strong>Objective: </strong>This study aimed to define the user requirements for a CVD app designed specifically for women. We sought to explore the unmet needs and challenges faced by female patients and their clinicians that current tools fail to address, and also to identify and prioritize features that would be most valuable and feasible to implement.</p><p><strong>Methods: </strong>We conducted a qualitative study using semistructured interviews to explore the needs, preferences, and expectations of women living with CVD and their treating clinicians. Guided by the human-centered design framework, this work focused on the "Define" phase. A total of 20 participants in Switzerland were interviewed, including 11 women with CVD, 7 cardiologists, and 2 experts in regulatory and reimbursement. Participants were recruited through purposive sampling, and interviews were conducted online between April and July 2025. Thematic analysis was used to synthesize the data, highlighting design priorities and contextual factors relevant for developing a patient-centered and system-aware digital health tool.</p><p><strong>Results: </strong>The interviews with women living with CVD and cardiologists confirmed the consistent gaps between existing care pathways and the specific needs of female patients. Both groups highlighted the lack of early symptom recognition, insufficient sex-specific guidance, and limited tools tailored to women's lived experience. While patients prioritized personalized education, emotional support, and features that address hormonal and life-stage-specific risks, clinicians emphasized clinical use, workload integration, and actionable summaries. Success was defined experientially by patients (eg, empowerment and reduced anxiety), and operationally by clinicians (eg, earlier detection and improved adherence). Willingness to pay was moderate among both groups, with patients favoring simplicity and clinicians emphasizing workflow integration and proven clinical use.</p><p><strong>Conclusions: </strong>These findings highlight the importance of designing an artificial intelligence-enabled CVD app for women that meaningfully integrates patient empowerment with clinical workflows. A dual-value approach is essential, offering personalized tools that address emotional and lifestyle needs for p
背景:由于在识别、诊断和针对性别特异性风险的护理方面存在差距,患有心血管疾病(CVD)的女性仍然得不到充分的服务。数字卫生工具有可能解决这些不平等现象,但许多工具未能反映妇女的独特需求。在之前的一项研究中,我们评估了20款心血管疾病应用和22款可穿戴设备,发现只有25%(5/20)的应用和40%(9/22)的可穿戴设备包含任何与性别相关的内容,比如激素周期跟踪和与怀孕或更年期相关的生命阶段考虑。这些发现证实,目前的数字工具在很大程度上反映了传统护理中的性别差距。目的:本研究旨在确定专门为女性设计的心血管疾病应用程序的用户需求。我们试图探索当前工具无法解决的女性患者及其临床医生未满足的需求和挑战,并确定和优先考虑最有价值和可行的实施特征。方法:我们采用半结构化访谈进行了一项定性研究,以探讨患有心血管疾病的女性及其治疗临床医生的需求、偏好和期望。在以人为中心的设计框架的指导下,这项工作集中在“定义”阶段。瑞士共有20名参与者接受了采访,包括11名患有心血管疾病的女性,7名心脏病专家和2名监管和报销方面的专家。参与者通过有目的的抽样招募,并在2025年4月至7月期间进行在线访谈。主题分析用于综合数据,突出设计重点和与开发以患者为中心和系统感知的数字健康工具相关的上下文因素。结果:对患有心血管疾病的女性和心脏病专家的访谈证实了现有护理途径与女性患者的具体需求之间存在一致的差距。两组都强调缺乏早期症状识别,缺乏针对性别的指导,以及针对女性生活经验的工具有限。当患者优先考虑个性化教育、情感支持以及解决激素和生命阶段特定风险的特征时,临床医生强调临床使用、工作量整合和可操作的总结。成功是由患者在经验上定义的(例如,授权和减少焦虑),以及由临床医生在操作上定义的(例如,早期发现和改善依从性)。两组的支付意愿都是中等的,患者倾向于简单,而临床医生强调工作流程的整合和临床应用。结论:这些发现强调了为女性设计一个人工智能支持的心血管疾病应用程序的重要性,该应用程序有意义地将患者授权与临床工作流程相结合。双重价值的方法是必不可少的,提供个性化的工具来满足患者的情感和生活方式需求,同时为临床医生提供简洁、可操作的见解。对监管和报销考虑的早期反思表明,模块化、基于证据的推广战略将是长期采用和规模化的关键。
{"title":"Bridging Gaps in Women's Heart Health: User-Centered Needs Assessment Informed by Patient and Clinician Interviews.","authors":"Christine Jacob, Sangeetha-Rose Puthanveettil, Patrick Vavken, Emel Kaplan, Christine S Zuern","doi":"10.2196/82916","DOIUrl":"10.2196/82916","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Women with cardiovascular disease (CVD) remain underserved due to gaps in recognition, diagnosis, and care tailored to sex-specific risks. Digital health tools have the potential to address these inequities, but many fail to reflect the distinct needs of women. In a prior review, we assessed 20 CVD apps and 22 wearables and found that only 25% (5/20) of apps and 40% (9/22) of wearables included any sex-specific content, such as hormone cycle tracking and life-stage considerations related to pregnancy or menopause. These findings confirm that current digital tools largely mirror the gender gaps seen in traditional care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to define the user requirements for a CVD app designed specifically for women. We sought to explore the unmet needs and challenges faced by female patients and their clinicians that current tools fail to address, and also to identify and prioritize features that would be most valuable and feasible to implement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a qualitative study using semistructured interviews to explore the needs, preferences, and expectations of women living with CVD and their treating clinicians. Guided by the human-centered design framework, this work focused on the \"Define\" phase. A total of 20 participants in Switzerland were interviewed, including 11 women with CVD, 7 cardiologists, and 2 experts in regulatory and reimbursement. Participants were recruited through purposive sampling, and interviews were conducted online between April and July 2025. Thematic analysis was used to synthesize the data, highlighting design priorities and contextual factors relevant for developing a patient-centered and system-aware digital health tool.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The interviews with women living with CVD and cardiologists confirmed the consistent gaps between existing care pathways and the specific needs of female patients. Both groups highlighted the lack of early symptom recognition, insufficient sex-specific guidance, and limited tools tailored to women's lived experience. While patients prioritized personalized education, emotional support, and features that address hormonal and life-stage-specific risks, clinicians emphasized clinical use, workload integration, and actionable summaries. Success was defined experientially by patients (eg, empowerment and reduced anxiety), and operationally by clinicians (eg, earlier detection and improved adherence). Willingness to pay was moderate among both groups, with patients favoring simplicity and clinicians emphasizing workflow integration and proven clinical use.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;These findings highlight the importance of designing an artificial intelligence-enabled CVD app for women that meaningfully integrates patient empowerment with clinical workflows. A dual-value approach is essential, offering personalized tools that address emotional and lifestyle needs for p","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e82916"},"PeriodicalIF":3.0,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12848491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967246","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
Utilization of AI Among Medical Students and Development of AI Education Platforms in Medical Institutions: Cross-Sectional Study. 医学生对人工智能的利用与医疗机构人工智能教育平台的发展:横断面研究
IF 3 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2026-01-08 DOI: 10.2196/81652
Xiaokang Shi, Zewu Jiang, Li Xiong, Ka-Chun Siu, Zhen Chen

Background: The emergence of artificial intelligence (AI) is driving digital transformation and reshaping medical education in China. Numerous medical schools and institutions are actively implementing AI tools for case-based learning, literature analysis, and lecture support. This expanding application is accelerating the adoption of localized AI platforms, which are poised to become integral components in the coming years.

Objective: The primary aim of this study was to investigate the current use of AI tools among medical students, including usage frequency, commonly used platforms, and purposes of use. The second aim was to explore students' needs and expectations toward AI-powered medical education platforms by collecting and assessing student feedback, and to identify practical requirements across disciplines and academic stages to inform more effective platform design.

Methods: Based on the task-technology fit model and 5 hypotheses, an anonymous online questionnaire was conducted to assess AI usage in learning, gather student feedback on AI-powered medical education platforms, and evaluate expected functionalities. The survey was conducted from March 1 to May 31, 2025, using a convenience sampling method to recruit medical students from various disciplines across Shanghai, China. The sample size was determined at 422, accounting for a 10% rate of invalid responses. The questionnaire was developed and distributed online via Wenjuanxing and promoted through WeChat groups and in-person interviews. Data analysis was conducted employing IBM SPSS Statistics (v 27.0).

Results: A total of 428 valid questionnaires were collected. The average frequency of AI-assisted learning among medical students was 5.06 (SD 2.05) times per week. Over 90% (388/428) of the students used more than 2 AI tools in their daily tasks. Students from different disciplines, educational stages, and academic systems demonstrated different usage patterns and expectations for AI-powered medical education platforms.

Conclusions: AI technology is widely accepted by medical students and is extensively applied across various aspects of medical education. Significant differences are observed in usage patterns across disciplines, educational stages, and academic systems. Understanding the actual needs of students is crucial for the construction of AI-powered medical education platforms.

背景:人工智能(AI)的出现正在推动中国医学教育的数字化转型和重塑。许多医学院和机构正在积极实施基于案例的学习、文献分析和讲座支持的人工智能工具。这种不断扩大的应用正在加速采用本地化的人工智能平台,这些平台有望在未来几年成为不可或缺的组成部分。目的:本研究的主要目的是调查医学生使用人工智能工具的现状,包括使用频率、常用平台和使用目的。第二个目标是通过收集和评估学生的反馈,探索学生对人工智能医学教育平台的需求和期望,并确定跨学科和学术阶段的实际需求,为更有效的平台设计提供信息。方法:基于任务-技术拟合模型和5个假设,进行匿名在线问卷调查,评估人工智能在学习中的使用情况,收集学生对人工智能医学教育平台的反馈,并评估预期功能。该调查于2025年3月1日至5月31日进行,采用方便抽样的方法,从中国上海的各个学科招募医学生。样本量确定为422,占无效应答率的10%。调查问卷通过“问卷行”在线发布,并通过微信小组和面对面访谈的方式进行推广。采用IBM SPSS Statistics (v 27.0)进行数据分析。结果:共回收有效问卷428份。医学生人工智能辅助学习的平均频率为5.06次/周(SD 2.05)。超过90%(388/428)的学生在日常工作中使用2个以上的人工智能工具。来自不同学科、教育阶段和学术体系的学生对人工智能医学教育平台表现出不同的使用模式和期望。结论:人工智能技术被医学生广泛接受,广泛应用于医学教育的各个方面。在不同学科、教育阶段和学术系统的使用模式中可以观察到显著的差异。了解学生的实际需求对于构建人工智能医学教育平台至关重要。
{"title":"Utilization of AI Among Medical Students and Development of AI Education Platforms in Medical Institutions: Cross-Sectional Study.","authors":"Xiaokang Shi, Zewu Jiang, Li Xiong, Ka-Chun Siu, Zhen Chen","doi":"10.2196/81652","DOIUrl":"10.2196/81652","url":null,"abstract":"<p><strong>Background: </strong>The emergence of artificial intelligence (AI) is driving digital transformation and reshaping medical education in China. Numerous medical schools and institutions are actively implementing AI tools for case-based learning, literature analysis, and lecture support. This expanding application is accelerating the adoption of localized AI platforms, which are poised to become integral components in the coming years.</p><p><strong>Objective: </strong>The primary aim of this study was to investigate the current use of AI tools among medical students, including usage frequency, commonly used platforms, and purposes of use. The second aim was to explore students' needs and expectations toward AI-powered medical education platforms by collecting and assessing student feedback, and to identify practical requirements across disciplines and academic stages to inform more effective platform design.</p><p><strong>Methods: </strong>Based on the task-technology fit model and 5 hypotheses, an anonymous online questionnaire was conducted to assess AI usage in learning, gather student feedback on AI-powered medical education platforms, and evaluate expected functionalities. The survey was conducted from March 1 to May 31, 2025, using a convenience sampling method to recruit medical students from various disciplines across Shanghai, China. The sample size was determined at 422, accounting for a 10% rate of invalid responses. The questionnaire was developed and distributed online via Wenjuanxing and promoted through WeChat groups and in-person interviews. Data analysis was conducted employing IBM SPSS Statistics (v 27.0).</p><p><strong>Results: </strong>A total of 428 valid questionnaires were collected. The average frequency of AI-assisted learning among medical students was 5.06 (SD 2.05) times per week. Over 90% (388/428) of the students used more than 2 AI tools in their daily tasks. Students from different disciplines, educational stages, and academic systems demonstrated different usage patterns and expectations for AI-powered medical education platforms.</p><p><strong>Conclusions: </strong>AI technology is widely accepted by medical students and is extensively applied across various aspects of medical education. Significant differences are observed in usage patterns across disciplines, educational stages, and academic systems. Understanding the actual needs of students is crucial for the construction of AI-powered medical education platforms.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e81652"},"PeriodicalIF":3.0,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12782625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145935455","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
期刊
JMIR Human Factors
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1