JMIR Human Factors最新文献

Background: Digital health tools such as smartphone apps have the potential to improve supportive cancer care. Although numerous smartphone apps for supportive care are available, few are designed using a user-centered approach. Such an approach is crucial for successful implementation, as it may improve user engagement, usability, and adoption in clinical settings.

Objective: This study aimed to co-design and develop a digital health app for supportive cancer care in collaboration with patients with cancer and health care professionals and to explore factors influencing its future acceptance.

Methods: We conducted a participatory study with the major stakeholders at the University Hospital Zurich. Workshops, individual qualitative interviews, and focus groups were held with health care professionals, survivors of cancer, and patients with cancer. The co-design process was divided into 3 phases: predesign, generative phase, and prototyping. User-centered design methods included scoring cards and think-aloud protocols to co-create design ideas, identify important functionalities, and test usability. Qualitative data were analyzed using thematic analysis.

Results: Patients and health care professionals emphasized the need for a digital health app to improve patient-healthcare professional communication, digitalize supportive care screening and processes, and enhance self-efficacy. The resulting app, OncoSupport+, was co-designed and integrated into the clinical workflow for supportive cancer care. It consists of (1) a patient dashboard to record patient-reported outcome measures and to provide access to personalized supportive care information and contact details, and (2) a nurse dashboard to visualize patient data, which can be used during nursing consultations. Potential facilitators for adoption included ease of use, workflow integration, introduction by health care professionals, and technical support, whereas internet anxiety may be a potential barrier.

Conclusions: Collaborative development with patients and health care professionals is crucial for creating digital health tools that can be implemented successfully. Future research should evaluate the feasibility of long-term implementation and the real-world usability and effectiveness of OncoSupport+ for improving communication, self-efficacy, and quality of life.

[This corrects the article DOI: 10.2196/59558.].

Background: Telepsychiatry has gained considerable attention, particularly during the COVID-19 pandemic. Although various factors influence the choice between online and offline modalities, differences among populations remain underexplored.

Objective: This study aims to compare adults seeking mental health support online and offline in private clinics.

Methods: In this cross-sectional study, we assessed differences in sociodemographic factors, internet accessibility and usability, previous help-seeking history, personality traits assessed using the Arabic Big Five Personality Inventory, and levels of self-stigma measured using the Self-Stigma of Seeking Help Scale.

Results: In total, 259 participants were included (136 online and 123 offline). The online group had a higher proportion of university graduates (P=.02), employed individuals (P<.001), and those with better internet access (P=.03) and higher internet usability (P=.001). The offline group showed higher levels of conscientiousness (P=.003). The primary reasons for choosing online therapy were ease of access and time-saving. Logistic regression identified previous use of online psychiatry as the strongest factor associated with choosing online services (odds ratio [OR] 28.90, 95% CI 11.739-71.165; P<.001). Employment (OR 5.01, 95% CI 1.781-14.080; P=.002), better internet usability (OR 1.69, 95% CI 1.069-2.664; P=.03), and agreeableness (OR 1.16, 95% CI 1.001-1.351; P=.05) were also significant factors. In contrast, previous in-person visits (OR 0.11, 95% CI 0.048-0.269; P<.001), openness (OR 0.85, 95% CI 0.748-0.975; P=.02), and conscientiousness (OR 0.86, 95% CI 0.758-0.971; P=.02) were negatively associated with online preference.

Conclusions: This study highlights key differences between online and offline mental health help seekers, enhances our understanding of treatment modality preferences, and paves the way for future research.

Background: The growing prevalence of allergic diseases alongside a shortage of trained allergists creates significant challenges in delivering timely care, especially for underserved populations. Telemedicine presents a promising solution, offering remote care through digital tools. While telemedicine has been widely adopted in other fields, its use in allergy care remains underexplored.

Objective: This study aimed to assess the potential of telemedicine in managing allergic diseases by examining patient preferences and experiences.

Methods: A survey of 27 questions was distributed to adult patients (>18 y) with allergic diseases attending the outpatient allergy clinic at the Division of Allergy, University Hospital Basel, Basel, Switzerland, between May and August 2024. The survey covered demographic information, prior use of telemedicine, and preferences for teleconsultation modalities. It also assessed patients' willingness to share various types of clinical data, including images and written reports, and explored which allergic diseases were considered appropriate for telemedicine.

Results: A total of 102 patients participated in the survey, with a mean age of 44.4 years (SD 16.7 y). For further analysis, the patients were stratified into four age groups: 18-34 years (36/102), 35-49 years (26/102), 50-64 years (31/102), and ≥65 years (9/102). Among them, 44% (41/94; P=.22) had previously used telemedicine services, with 34% (32/94; P=.04) specifically using it for allergic diseases. When asked about consultation formats, 49% (49/100) of patients preferred in-person visits, while 41% (41/100) favored a hybrid model combining telemedicine and in-person care. Regarding telemedicine tools, 57% (51/89) preferred telephone consultations with a doctor. Patients would use telemedicine preferentially for mild compared to severe allergic diseases as well as for chronic compared to acute conditions. The spectrum of diseases for which patients would use telemedicine comprised a wide range of allergic conditions, with allergic rhinoconjunctivitis (16%; 14/85), Hymenoptera venom allergy (13%; 11/85), and food allergy/intolerance (13%; 11/85) cited most frequently. Only 7% (6/85) of patients indicated they would not use telemedicine for any allergic disease.

Conclusions: This study emphasizes the growing adoption and importance of telemedicine in allergy care, with a significant proportion of patients already having experience using it for managing allergic diseases. Patients' inclination toward multiple communication formats underscores the growing need for individualized management of allergic diseases.

Background: The rapid expansion of virtual care during COVID-19 accelerated the development of virtual hospital-at-home models, which deliver hospital-level care in patients' homes through remote monitoring, virtual communication, and in-person support when required. While the virtual hospital-at-home model offers the potential to improve patient-centered care and health equity, rapid implementation often overlooks culturally diverse and underserved populations, including South Asian communities who experience disproportionate chronic disease burden and barriers to accessing culturally relevant services. Strategies are needed to ensure equitable design and adoption of virtual hospital-at-home models.

Objective: This study used an experience-based co-design (EBCD) approach to engage patients, caregivers, clinicians, and community organizations in shaping a regional virtual hospital-at-home strategy within the Fraser Health Authority, British Columbia, Canada. The aim was to identify barriers, facilitators, and equity-focused solutions to inform future implementation.

Methods: We conducted a five-stage EBCD quality improvement process in the Fraser Health Authority, British Columbia, including (1) forming a multidisciplinary steering committee, (2) reviewing health care provider experiences, (3) interviewing South Asian patients and caregivers, (4) hosting a co-design workshop to develop solutions, and (5) sharing back findings.

Results: Participants identified barriers, including digital literacy, language, and trust in virtual care. The co-designed solutions focused on culturally tailored education, hybrid digital training, caregiver inclusion, and community-driven engagement strategies.

Conclusions: EBCD enabled the development of inclusive and actionable strategies to improve virtual hospital-at-home services. The findings highlight the importance of ongoing community collaboration to ensure equity in virtual care innovation.

Background: Latinas are one of the largest and fastest-growing female ethnic groups in the United States and have high levels of physical inactivity and sedentary behavior (SB), contributing to a disproportionate burden of chronic health conditions. An ecological momentary assessment (EMA) involves the use of smartphone-based data collected in real time to assess health behaviors and outcomes.

Objective: We examined the feasibility, validity, and acceptability of an EMA protocol assessing physical activity (PA) and SB in Latina adults.

Methods: For 7 days, 67 Latinas (average age 39 years, SD = 13.6; n=37, 55.2% earning less than US $50,000/year; n=53, 79.1% foreign-born; and n=49, 73.1% of Mexican or Mexican American origin) completed a signal-contingent EMA protocol with 3 prompts per day and wore an ActiGraph GT3X accelerometer to measure levels of PA and SB. EMA prompts inquired about current behavior, feelings, beliefs, social conditions, and contexts.

Results: Latinas completed 69.7% (892/1279) of EMA prompts. They were more likely to respond to EMA prompts when engaged in more SB (odds ratio [OR] 1.04, 95% CI 1.01-1.06) and less light-intensity PA (OR 0.97, 95% CI 0.94-0.99) in the 30 minutes around the prompt. Accelerometer data validated self-reported occasions of PA and SB via EMA. The majority of participants (>70%) were satisfied with the protocol and expressed interest in participating in future studies.

Conclusions: EMA is a feasible, valid, and acceptable methodology for capturing movement behaviors among Latinas, which can provide insights into the antecedents and consequences of these behaviors in their daily lives.

Background: Diagnostics, treatment, and research of persisting postconcussion symptoms are challenging. Assessing symptoms is essential, but currently implemented methods only allow for retrospective reporting of symptoms. A mobile health (mHealth) symptom mapping app for adults with persisting postconcussion symptoms may be an accessible and cost-efficient alternative.

Objective: This study aimed to develop a research-based mobile app for symptom mapping for adults with persisting postconcussion symptoms and investigate its usability, feasibility, and safety.

Methods: This was a mixed method development and usability study consisting of three iterative cycles, each including (1) app design and programming, (2) app usability evaluation by the user group, and (3) app review by the clinician group. The outcomes were the mHealth App Usability Questionnaire and Mobile App Rating Scale scores, the number of days with logged symptom data during a home-testing period, and descriptions of adverse events throughout the study period. Semistructured interviews were conducted to explore the user group's experiences further.

Results: Twenty-three adults with persisting postconcussion symptoms (median age 52, IQR 34-59 years; 70% female) were included in the user group. Six clinicians (median age 53, IQR 35-60 years), including 3 (50%) females, with a mean of 13 (SD 7) years of experience working with individuals with persisting postconcussion symptoms, were included in the clinician group. The app received a mean score of 5 (SD 1.1) on the mHealth App Usability Questionnaire (7-point Likert scale) from the user group and 4.1 (SD 0.4) on the Mobile App Rating Scale (5-point Likert Scale) from the clinician group. During the 28-day home-testing period, the adherence rate among the participants in the user group was 89% (IQR 78-96), and two adverse events related to increased symptom awareness were registered. Three themes were created through reflexive thematic analysis of the qualitative data: (1) Visualizing the invisible-Enabling reflection and insight; (2) Personalized yet simple-Balancing relevance and usefulness; and (3) More than just a number-The complexity behind the symptom scores.

Conclusions: We developed a research-based symptom mapping app for people with persisting postconcussion symptoms. The app received high usability ratings from both the user and clinician groups. The app is a feasible alternative to traditional symptom mapping methods, and it is safe to use for its intended purpose.

Background: Web-based mental health forums have the potential to play a significant role in providing accessible support for young people, supplementing in-person services and contributing positively to their mental well-being. However, limited engagement often constrains their impact and effectiveness in supporting young people.

Objective: Using the Behavior Change Wheel framework, this qualitative study explores the barriers and facilitators to young people's engagement with web-based mental health forums, focusing on the behaviors of creating new posts, responding to posts, and reading posts. Behavior change techniques (BCTs) are identified to address these barriers.

Methods: Semistructured interviews were conducted with 13 young people aged 17-25 years who use UK-based youth mental health forums. Three participants self-identified as men, 8 as women, 1 as nonbinary, and 1 chose not to disclose their gender. Transcripts were coded using the Theoretical Domains Framework (TDF), followed by inductive theme generation. TDF barriers were then mapped to BCTs to suggest intervention strategies.

Results: Thematic analysis revealed ten inductive themes across 5 TDF domains. Of these, 3 were enablers, 2 were barriers, and 5 functioned as both enablers and barriers. The findings indicated that skills, beliefs about consequences, emotions, and the social and physical environment are key influences on young people's engagement with web-based mental health forums. Positive emotions experienced after using the forums enabled posting, responding, and reading behaviors. Enablers of more active participation (ie, posting and responding) included anonymity and positive interactions with other users. The presence of moderators acted as an enabler for all 3 behaviors by providing a safe environment, but also as a barrier to posting, as moderation could restrict the content of users' posts. Similarly, mobile access facilitated posting, responding, and reading, whereas layouts not optimized for mobile use acted as barriers to typing and reading on the go.

Conclusions: This study contributes to the existing knowledge base by examining the different ways in which young people engage with youth mental health forums. Different strategies may be prioritized and adopted depending on whether forum providers aim to increase more active forms of engagement (eg, posting and responding, which can be encouraged by fostering positive interactions with other users) or overall engagement (eg, establishing clear rules of engagement and optimizing web page content for mobile access can benefit all forms of engagement). These insights can help improve the delivery of youth mental health forums and foster a positive ecosystem of support for young people.

Background: With the rising global adoption of telemedicine, there is a crucial need to address inefficiencies and challenges in current service systems. This case study focused on enhancing the telemedicine service system of a traditional Chinese medicine clinic.

Objective: The primary objective was to identify and address pain points and inefficiencies in the existing telemedicine system with the aim of streamlining service operations for the benefit of both patients and service providers.

Methods: Through comprehensive service design analysis, including the creation of a customer journey map and a service blueprint, key areas for improvement were identified, and the service process was redesigned accordingly. A user-friendly web application was developed and evaluated using usability testing and satisfaction assessments. Participants took part voluntarily. Task testing was conducted using real-world scenarios, with index of item-objective congruence values ranging from 0.84 to 1.00. Participants were assigned role-specific tasks as either patients or service providers in a step-by-step format, followed by role-specific paper-based questionnaires.

Results: The redesigned system successfully streamlined operations by automating processes and reducing task complexity, resulting in improved time efficiency for both user groups. Participants included 6 patients (aged 23-54 years) and 7 service providers from various departments. Usability testing revealed a task success rate of 100% for all tasks among patients, coordinators, physicians, and finance personnel as well as 83.33% among pharmacists. Satisfaction outcomes were positive: patients reported a net promoter score of 67, whereas service providers reported a mean System Usability Scale score of 71.4 (SD 20.76).

Conclusions: This study highlights the transformative potential of telemedicine in health care delivery. For patients, consolidating services into a single digital platform improved accessibility and ease of use. For service providers, the system reduced repetitive tasks and facilitated more efficient task completion. These findings demonstrate the effectiveness of service design methodologies in enhancing telemedicine systems, ultimately contributing to improved health care quality and patient outcomes.