Background: We co-designed the novel multicomponent CAPS (Care Assistant and support Program for people after Stroke or transient ischemic attack) to augment the secondary prevention of stroke.
Objective: Following completion of a feasibility study, we sought feedback from Australian clinicians and service provider representatives (the potential deliverers of CAPS) regarding their perceptions of CAPS for secondary prevention and the pathways to real-world adoption.
Methods: This was a qualitative descriptive study of clinicians and service provider representatives involved in the delivery of stroke care around Australia. A pragmatic convenience sample was obtained by contacting previous CAPS co-design study participants; leveraging professional networks (eg, LinkedIn); and distributing study flyers and newsletters via primary health care networks, general practitioner (GP) networks, and social media posts (Commonwealth Scientific and Industrial Research Organization's LinkedIn pages). Semistructured interviews and focus groups were conducted virtually with clinicians and representatives of the Stroke Foundation (Australia). Qualitative content analysis was undertaken.
Results: Overall, 18 clinicians and 3 Stroke Foundation representatives participated from 5 Australian states, including medical specialists, GPs, nurses, and allied health professionals. We collected their perceptions of CAPS, categorized as potential benefits of the program for secondary prevention, and the considerations for facilitators and challenges to real-world program implementation. The perceived benefits of supporting self-management for patients and facilitating informed decision-making for clinicians were identified. Discussions regarding program implementation included program initiation and duration, patient support considerations, and workflow alignment, which involved consideration of the barriers and enablers to uptake within primary care practice and Stroke Foundation outreach support programs.
Conclusions: There was support from participants for the potential of CAPS to improve the secondary prevention of stroke. However, approaches for addressing the challenges raised by participants, including further implementation and integration considerations, such as sustainability of the model of care, are likely required for CAPS to be successfully embedded within clinical settings.
Background: The collection of dietary behavior data is crucial in childbearing populations. In addition to observed inequities in perinatal dietary intake and quality, burdensome assessment methods (eg, 24-h dietary recall) may limit research participation for some groups. Ecological momentary assessment (EMA) is associated with reduced recall bias and participant convenience, but there is a dearth of studies with diverse cohorts.
Objective: Our aim is to describe participant completion of food intake items in EMA surveys, overall and across individual characteristics (eg, prepregnancy BMI).
Methods: Using secondary EMA data from participants in a longitudinal study, we report average completion rates of survey items regarding dietary behavior (eg, number of meals eaten in a day) across individual demographic variables (eg, age) and combined strata (eg, race+age) during late pregnancy and throughout 12 months post partum.
Results: In our analytic sample (N=310), the average completion rate was 52.4% (SD 27.8%) during pregnancy, rising to 59.1% (SD 22.0%) after giving birth. Participants who were older (>30 y), overweight before pregnancy, self-identified as White, working, or earning higher annual income (>US $50,000) had higher average completion rates than their counterparts. Examining combined strata, we found some variation in survey completion within racial groups. Black participants using a study phone had higher average completion rates during pregnancy and post partum, but this relationship was reversed for White participants.
Conclusions: Our secondary analysis showed relatively stable engagement with EMA surveys in a childbearing cohort across 15 months. Increased completion rates among privileged groups (eg, White, higher income) may demonstrate the impact of socioeconomic advantages on individual health behaviors. Investigators should consider how intersections between race and other factors (eg, employment) may impact participation and data collection.
[This corrects the article DOI: 10.2196/32174.].
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.
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