JMIR Human Factors最新文献

Background: The existing intravenous systemic anticancer therapy (SACT) pathway in pharmacies is operationally inefficient. Manual, paper-based workflows render the system prone to human error, and the need for time-consuming manual verification diverts pharmacy staff time. The introduction of an automated workflow solution for the intravenous SACT pathway could optimize treatment timeliness and improve oncological outcomes for patients, aligning with the National Health Service Long Term Plan for improved cancer care.

Objective: This observational analysis aimed to assess the change in time, cost, and errors following the implementation of the Becton Dickinson (BD) Cato Pharmacy system in an aseptic unit producing intravenous SACT at Watford General Hospital.

Methods: Data on compounding process times were collected manually by pharmacy staff before and after the implementation of the intravenous compounding software (BD Cato). The data were analyzed to estimate annual time savings, opportunity cost savings, and error reduction.

Results: The intravenous compounding software produced a time saving of 18 (SD 9) minutes per drug, equating to 1034 hours saved per year (1034/2591, 39.9% reduction). If this time were repurposed to producing more intravenous SACT, Watford General Hospital could increase production by 66% (2298/3482) annually (2298 additional intravenous SACT). This represents an average cost saving of £11.29 (£1=US $1.273) per drug, equating to an annual opportunity cost saving of £39,246. The intravenous compounding software also decreased observed errors by 86% (43/50), a reduction of 43 errors over 2 months (approximately 258 fewer errors annually). Staff also preferred the intravenous compounding software to the manual system.

Conclusions: Implementing intravenous compounding software can save time, reduce costs, and lower errors in intravenous SACT preparation. This could improve timely treatment access for patients with cancer.

Background: With the global increase in population aging, promoting walking as a health behavior to maintain and enhance well-being among older adults has become increasingly important. In recent years, advances in information and communication technology and mobile health have supported the development of health interventions delivered through smartphone apps. However, no review to date has included psychological aspects such as motivation or intention to walk, and the behavior change techniques (BCTs) embedded in smartphone apps that effectively promote walking remain unclear.

Objective: This study had 2 primary aims: (1) to evaluate the effects of smartphone app use on walking behavior and intention to walk among community-dwelling older adults and (2) to identify the specific BCTs delivered through these apps that may promote walking behavior and intention effectively.

Methods: Eligible studies were those published in English or Japanese between March 1, 2015, and February 28, 2025, that focused on community-dwelling older adults, implemented smartphone app-based interventions, and reported walking-related outcomes. A systematic search strategy was designed using keywords such as "older," "smartphone," and "walking." Risk of bias was evaluated using the Study Quality Assessment Tools. The features of the apps described in the selected studies were examined to identify the BCTs they used, as categorized by the BCT Taxonomy.

Results: Of the 296 studies initially retrieved, 8 met the inclusion criteria. These studies varied in terms of participant characteristics, intervention duration, app features, and outcomes, and most were pilot studies. While several apps were designed specifically to increase walking, others included features that facilitated social interaction among users. In addition, 2 studies also reported improved motivation to walk. Apps that were associated with statistically significant improvements in walking behavior frequently used BCTs from the following clusters: (1) goals and planning, (2) feedback and monitoring, and (4) shaping knowledge. Notably, 5 BCTs were not incorporated into any of the reviewed apps.

Conclusions: Although smartphone apps have the potential to improve walking behavior and intention among community-dwelling older adults, the current body of evidence remains limited. Apps that deliver walking-related knowledge, facilitate goal setting, and support behavioral monitoring appear especially effective and may strengthen walking behavior and intention in this population.

Background: Adolescents face a variety of potential harms in the online environment, including exposure to distressing illegal material, cyberbullying, image-based abuse, and "sextortion." Various agencies provide on-demand helpline and information services for children and adolescents to support them with navigating online (and offline) harms.

Objective: This study examined whether a chat-based conversational agent (chatbot) might be a useful additional tool for meeting the needs of adolescents at risk from online harms. We developed a prototype chatbot-including both conversational and menu-driven user options-and evaluated users' trust in the chatbot. In this context, trust relates to perceptions of the chatbot's usability and the value of the information and support it provides.

Methods: Participants (n=224; mean age 16.8 years) interacted with the chatbots and evaluated them in terms of user trust: perceived usability and utility (ie, relevance of support resources provided).

Results: Most participants (conversational chatbot: 141/224, 63% and menu-driven chatbot: 142/224, 63%) showed a willingness to click on the chatbots' recommended support links. Participants with higher trust in the chatbots were more likely to click the links for recommended support services (with extreme evidence for large effects: δ=0.73, 95% credible interval [CrI] 0.46-1.00 and δ=0.78, 95% CrI 0.50-1.07, for the conversational and menu-driven chatbots, respectively; Bayes factor [BF₁₀]>50,000), and participants who clicked the links, compared with those who did not, reported higher rates of positive attitudes toward their decision (with extreme evidence for large effects: δ=0.87, 95% CrI 0.58-1.15 and δ=0.84, 95% CrI 0.54-1.12, for the conversational and menu-driven chatbots, respectively; BF₁₀>3,000,000). The conversational and menu-driven chatbots differed little in perceived trust or effectiveness.

Conclusions: Chatbots represent a promising additional tool to help adolescents access mental health-related support services and navigate online harms. However, establishing trust is critical.

Background: Although chronic pain (CP) is highly prevalent, current modalities are not sufficient to address the needs of people living with this condition. Pharmacological treatments for CP can have severe side effects and increased likelihood of patients overdosing or developing addiction. Behavioral treatments are often indicated for the treatment of CP, but barriers to treatment are common. Virtual reality (VR)-based interventions have shown promise as an effective and potentially accessible form of treatment for CP. However, previous research on VR interventions for people living with CP has not often included diverse populations, including racial and ethnic minority groups and people with low socioeconomic status.

Objective: This study aimed to gauge the interest of patients with CP in participating in a hypothetical study of at-home VR for CP and to identify predictors of interest. Patients were recruited from a low socioeconomic and racially and ethnically diverse community.

Methods: A total of 48 participants living with CP were recruited from an electronic medical record database, a research participant database, and a pain clinic, and they completed surveys about demographics, pain levels, technology use, and knowledge of VR. Bivariate testing was used to determine which, if any, of the aforementioned variables were associated with interest in a hypothetical study of at-home VR for CP. Stepwise logistic regression models predicting interest were built based on bivariate testing. Finally, we used a thematic analysis framework to analyze an additional open-ended question about reasons for interest in participating in a VR intervention for CP.

Results: Despite low technology use and little knowledge and experience with VR, results showed high interest (42/48, 88%) among patients in participating in a hypothetical study of at-home VR for CP. More frequent email use and using Facebook demonstrated nonsignificant trends toward interest in participating in a VR clinical trial for pain (P=.06 for email use and P=.06 for Facebook use). In stepwise multivariate models controlling for pain score, Facebook use was predictive of being somewhat or very interested in participating in a VR clinical trial for pain (P=.047). Open-ended responses tended to cite the novelty of VR and desperation for pain relief as reasons for participants' interest.

Conclusions: We found high interest in participating in a clinical trial of VR despite low use of technology and low knowledge of VR. Future fully powered studies should seek to confirm the effectiveness of VR treatments for people with CP, especially people from lower socioeconomic, and racially and ethnically diverse backgrounds.

Background: Recruiting patients in primary care research remains challenging due to clinical workload, staffing constraints, and the need to limit disruption to routine care. Traditional recruitment methods often place a substantial burden on clinics, prompting research teams to adopt low-burden and scalable approaches such as email-based recruitment. Despite its growing use, limited empirical evidence describes how email recruitment campaigns are designed and how they perform when targeting primary care patients in real-world settings.

Objective: This article aims to descriptively examine engagement metrics from an email recruitment campaign targeting primary care patients.

Methods: We conducted a formative, descriptive secondary analysis of engagement metrics generated during a large-scale email recruitment campaign conducted as part of the Quebec component of the PaRIS-OECD survey. Between June 2023 and January 2024, 12 primary care clinics invited eligible adult patients (≥45 years) to complete an online survey using a standardized email template distributed via an email marketing platform. Collected engagement metrics included delivery rates, open rates, click-through rates, conversion rates and device type. Analyses were descriptive and conducted at the clinic level.

Results: Invitations were successfully delivered to 14,758 patients (97%). The mean open rate for the initial invitation was 73% (range: 57%-88%), decreasing with reminders. Most emails were opened on computers (85%). A total of 445 emails were undelivered due to technical issues (n = 42) or incorrect email addresses (n = 403). The overall conversion rate was 10%. Click-through rates varied by content, with the highest engagement observed for the survey link and lower engagement for supplementary video materials. Reminder emails substantially increased survey participation across clinics (200%). Participants who completed the questionnaire were predominantly aged.

Conclusions: This formative analysis suggests that email-based recruitment is a feasible and low-burden approach for engaging primary care patients in research. Engagement metrics offer valuable insights at the implementation level to inform the design, adaptation, and monitoring of digital recruitment strategies in real-world primary care settings. These findings provide practical, implementation-oriented insights to inform the design, refinement, and evaluation of email recruitment campaigns in primary care research.

Clinicaltrial:

Background: Patient autonomy through informed consent is a foundational ethical principle for health care practitioners. Online consent processes risk producing "consent in name only," using manipulative or confusing user interfaces to extract consent artificially. This presents a significant danger for safe and ethical remote consultations for primary care providers, which often extract significant amounts of sensitive personal data.

Objective: This study aims to examine the quality of consent obtained through both currently used and novel consent acquisition interfaces for remote e-consultations between a patient and a primary care provider.

Methods: A total of 55 adult participants in the United Kingdom completed an interaction with a mock-up e-consultation system's consent interface for data processing, with 54 completing the full study protocol. The participants were then asked questions regarding what they had provided consent for and the usability of the interface. These responses led to the calculation of an industry-standard System Usability Scale (SUS) score and a novel Quality of Informed Consent Collected Digitally (QuICCDig) score.

Results: Users perceiving interfaces to be more usable (with a greater SUS score) were statistically significantly (n=54; P=.004) correlated with an increase in the quality of consent collected from those users (with a higher QuICCDig score). Nonetheless, both existing and novel user interfaces for collecting e-consultation consent were rated poorly, achieving a maximum SUS letter grade of "F." In total, 45% (25/55) of all the participants reported not recalling making a privacy-related decision at all during their consultation, and 87% (48/55) did not recall being offered any alternatives to e-consultation.

Conclusions: The findings demonstrate that current methods for collecting consent in telemedical applications may not be fit for purpose and potentially fail to collect valid informed consent. However, increased usability scores from users do appear to drive improvements in the quality of consent collected. Therefore, decision-makers should place importance on high-quality interface design when building or procuring these systems. We have also provided the QuICCDig score for further use.