Background: Patients with long-term conditions, such as stroke, require regular follow-up visits to health care professionals to identify changes in symptoms. The digital previsit tool Strokehälsa (Strokehealth) has been designed to encourage individuals with stroke to reflect on stroke-related health concerns before a follow-up visit, thereby potentially enhancing their engagement during the visit. Strokehealth has previously been evaluated using a patient satisfaction survey (part 1), but there remains a need to further explore patients' perceptions and needs to optimize its functionality before broader implementation.
Objective: The overall aim was to attain deeper insights into patients' views and experiences of using the digital previsit tool Strokehealth before a follow-up visit. A secondary aim was to identify potential improvements to the tool based on these insights.
Methods: For this qualitative study, patients who had used Strokehealth version 1.0 before a follow-up visit were recruited through the previous survey between November 2020 and June 2021. Individual semistructured interviews were conducted, and data were analyzed using reflexive thematic analysis. Subsequent workshops were held with people with firsthand experiences of stroke, other stakeholders (including health professionals and researchers), and a web consultant to finalize decisions regarding adjustments to be implemented in Strokehealth version 2.0.
Results: Interviews were conducted with 33 participants (23 men and 10 women), with a median age of 67 (IQR 55-76) years. Analysis of the data regarding participants' experiences of using Strokehealth revealed three overarching themes: (1) a supporting tool for preparing dialogue and identifying needs, (2) how Strokehealth is introduced and communicated affects perceived usability, and (3) the wording and structure of Strokehealth influences the response process. The findings captured various aspects of receiving and using the digital previsit tool, highlighting its simplicity and purpose. Overall, Strokehealth was well received and contributed to a sense of being well cared for. Participants generally not only found Strokehealth easy to use but also shared suggestions on how to better address stroke-related issues, such as mental fatigue or pain. Examples of changes that have been implemented in Strokehealth version 2.0, based on participant feedback, include improved explanatory texts and expanded opportunities for free text.
Conclusions: The findings indicate that the freely available digital previsit tool Strokehealth was generally well received by patients with stroke who were scheduled for follow-up visits in outpatient settings.
Trial registration: Researchweb 275135; https://www.researchweb.org/is/vgr/project/275135.
Background: Mental disorders are the leading cause of disability in young people (aged 12-30 years), and their incidence constitutes a major health crisis. Primary youth mental health services are struggling to keep up due to overwhelming demand, the complexity and severity of young people presenting for care, and a shortage of qualified mental health professionals (MHPs). Artificial intelligence (AI) tools have the potential to facilitate necessary improvements to diagnosis, triage, and care planning for young people with emerging mental disorders.
Objective: The objective of the present scoping research was to examine beliefs and attitudes underlying MHP acceptance of AI tools in youth mental health services.
Methods: In total, 57 MHPs (mean age 35.35, SD = 9.50 years, 72% female (n = 39)) with experience working with youth populations (age 12-30) took part in study 1 that involved completing a web-based survey about the acceptability of using AI in early intervention services. During study 2, 15 MHPs also participated in 1-hour semistructured Zoom interviews. Attitudes toward the use of 2 novel AI prototypes (both of which provide recommendations for care coordination based on previously published data analyses) in youth mental health were explored. Quantitative data were interpreted using descriptive statistics, and qualitative analysis followed the thematic analysis approach.
Results: MHPs were more likely to agree than disagree that AI will improve youth mental health care overall (eg, n=37, 64% participants somewhat or strongly agree that the field of mental health will improve with AI). Despite voicing concerns regarding data security and privacy, MHPs also acknowledged a need for AI to improve the "signal-to-noise ratio" in services and address delays to care for those with severe and complex problems. Such problems were seen as pervasive across the youth mental health system and emphasize the serious costs of delaying the development and implementation of novel tools. All participating MHPs discussed the potential negative impacts of not adopting novel tools.
Conclusions: MHP acceptance and uptake of novel AI tools in youth mental health services will be driven by a more complex cost-benefit analysis of both adopting and not adopting, rather than solely on their design. The costs of delay are clear, and so researchers and MHPs have a shared imperative to develop useful and meaningful clinical tools and to work jointly on integrating them into practice. Limitations of our sample (including low sample size limiting generalizability) notwithstanding, these findings should inform the future design and implementation of such tools.
Background: Incorporating serious games and advancements in information and communication technologies into physical rehabilitation can substantially enhance the process, provide unique benefits, and improve its effectiveness and efficiency. While recent literature highlights various game-based interventions for physical rehabilitation, there is a lack of comprehensive guidance on how to design and develop systems that effectively address the actual needs of therapists, practitioners, and individuals with physical disabilities.
Objective: The objective of this study was to explore the intentions, needs, and desires of therapists and other practitioners, as well as to examine the factors and determinants influencing the effectiveness and efficacy of game-based physical rehabilitation, since therapists and other health care practitioners play crucial roles in both patient recovery and the establishment of an effective game-based therapy.
Methods: A design science approach was adopted to achieve this research objective. A focus group of 27 participants was conducted to gather feedback, identify user needs, and understand the requirements for game-based physical rehabilitation. The participants first tested commercially available games and then evaluated mock-ups of the proposed game prototypes.
Results: This study provides essential design insights and guidelines for designers and researchers, focusing on the practical needs and requirements of game-based physical rehabilitation systems.
Conclusions: As proof of concept, these guidelines will be used in the next phase of our research, which involves designing and developing a game-based physical rehabilitation system.
Background: Artificial intelligence (AI)-driven mobile health (mHealth) apps are emerging as a promising tool for health management, yet little is known about users' psychological perceptions and attitudes toward these technologies. Understanding these aspects is crucial for both the appropriate design and the effective use of these technologies, ensuring the psychological and physical well-being of potential end users.
Objective: This study aimed to investigate the attitudes and perceptions of young adults toward a possible use of AI-driven mHealth apps, focusing on the perceived benefits and potential concerns related to their future adoption.
Methods: A qualitative focus group methodology was used. Fifteen participants (12 men, 3 women; mean age 27 years, range: 25-34 years) were recruited. Data were analyzed using thematic analysis to identify key themes influencing engagement with these technologies.
Results: Four main themes emerged: "Usability," which emphasized the importance of user-friendly, personalized experiences; "Innovation and Reliability," where participants expressed both enthusiasm and skepticism towards AI's potential; "Affectivity and Interaction with AI," highlighting mixed opinions on the emotional impact of AI interactions; and "Perceived Risks," which focused on concerns regarding data privacy and the need for human supervision. These factors contributed to ambivalent attitudes toward AI-driven mHealth apps, with some participants being open to adoption, while others remained cautious.
Conclusions: To foster greater engagement with AI-driven mHealth apps, developers should prioritize usability, trust, emotional support, and privacy issues, considering users' psychological needs and expectations. The findings offer valuable insights for designing more user-oriented mHealth solutions. Further research should explore how perceptions evolve with direct experience and long-term use.
Background: There is an increased focus on involving members of the public in health research. These types of groups, such as "health consumer groups," bring different expertise to inform the design of a research study. There is a growing general concern about older adults' acceptance and use of technologies. This becomes critical when it involves health care services.
Objective: To understand the use of social robots among older adults, it is prudent to gauge stakeholders' perspectives on optimal research design. In line with the philosophy of the "triple helix model," researchers sought the expertise and guidance of a health consumer group.
Methods: Researchers recruited an expert health consumer group for this study. This included 5 participants from an 8-member panel. Semistructured interviews were conducted. Each interviewee was introduced to visual stimuli of assistive technologies, older adults, and social robots. Subsequently, they were asked for their perspectives on what they viewed and to provide guidance on how to best design upcoming research on these phenomena.
Results: Key themes were derived from the interview transcripts with the health consumer group members. Findings include panel members' advice and guidance on explaining the research aims to technology-averse older adults, approaching data collection from this demographic, and, finally, their perceptions of the appearance of social robots.
Conclusions: The advice and guidance of this expert health consumer, in tandem with researchers and industry partners, substantially aid in advancing research efforts toward social robot use among technology-averse older adults in Australia. This research provides vital information, including how best to approach data collection about social robots from this demographic.
Background: Smoking remains a leading cause of death worldwide, with young adults particularly at risk due to the lack of targeted cessation initiatives. While mobile apps show promise in supporting smoking cessation, they primarily target smokers already motivated enough to install them, highlighting the need for interventions that reach those who are not yet ready to take that step.
Objective: This paper focuses on designing and evaluating Smokwit, a digital smoking cessation intervention aimed at young adults during the act of smoking. Smokwit seeks to investigate the early stages of smoking cessation (precontemplation and contemplation) that are important yet rarely investigated.
Methods: The paper is based on the design science research methodology where a digital intervention-Smokwit-was designed and evaluated in the wild using a mixed method approach combining quantitative results of a quasi-experiment with qualitative insights from users and experts. More specifically, Smokwit is a novel gamified ambient intervention that integrates a connected ashtray with a mobile app. The ashtray aims to trigger processes of change, in particular consciousness raising and social liberation (as part of the transtheoretical model of change) by provoking curiosity, self-reflection, and ad-hoc peer discussions among smokers. The linked mobile app is designed to reinforce this goal by providing smoking cessation self-help material and coaching possibilities. We evaluated the effectiveness of this intervention through a 3-month field study designed as a quasi-experiment with a treatment and control group (n=46). A qualitative analysis with users (n=10) and smoking cessation experts (n=7) provides insights into the type of interactions that happened within and outside the system as well as practical implications for smoking cessation organizations.
Results: The qualitative findings revealed that the intervention promoted smokers' self-reflection, peer discussions, and mobile app interactions. Furthermore, the quantitative analysis uncovered a possible trend toward increased readiness to quit among smokers in the treatment group compared to the control group; however, this did not reach conventional levels of statistical significance (b=1.33; z=1.91; P=.06).
Conclusions: Smokwit provides encouraging insights into how to design a bottom-up digital intervention that targets young adults at an opportune moment to support them on their smoking cessation journey.
Background: In rural Australia, geographical isolation, limited resources, and complex health care navigation create significant barriers to mental health care access. Mental health care professionals and organizations often work in segregation, exacerbating existing barriers. Digital technology provides an opportunity to improve communication between providers and streamline workflows while supporting a diverse range of consumers.
Objective: This co-design study aimed to identify rural community needs and explore digital solutions to enhance mental health service delivery pathways.
Methods: Using a design-thinking methodology, we conducted focus groups and workshops with 17 participants (7 consumers and caregivers and 10 health care professionals) from a rural region to understand mental health service needs, systemic challenges, and design potential digital solutions. Thematic analysis followed a grounded theory approach, involving systematic coding and theme development through an iterative consensus process.
Results: Access to mental health care emerged as the central theme. Rural community participants reported strong community connections but faced challenges, including limited technological innovation and substantial travel burdens. Health care professionals highlighted critical systemic pressures: underresourcing, overwhelmed clinicians with extensive waitlists, and complex referral processes. Both groups identified overlapping barriers in service limitations and system navigation. During the design phase, we developed personas capturing consumer and health care professional experiences and conceptualized an integrated digital solution comprising a health care professional dashboard and a consumer-facing app with caregiver access to enhance service coordination.
Conclusions: The study demonstrated strong stakeholder support for implementing an integrated digital solution to enhance rural mental health service delivery. Further research is required to build upon the solution prior to testing, optimizing, and scaling.
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