Background: Delays in transporting sputum samples and medicines from peripheral health centers to diagnostic laboratories are a persistent barrier to timely tuberculosis (TB) diagnosis in rural India. Conventional transport methods are often constrained by poor road connectivity, long travel times, and logistical inefficiencies. Unmanned aerial vehicles/drones have shown promise in bridging such gaps in other low-resource and rural areas, yet there is limited evidence on their feasibility, acceptability, and integration within India's National TB Elimination Programme.
Methods: In the present qualitative study, 28 in-depth interviews and 12 focus group discussions with 101 purposively selected stakeholders were conducted to understand the feasibility across the five components: acceptability, demand, practicality, implementation, and integration. Data were thematically analyzed using a feasibility framework. Ethical approval was obtained from the Institutional Ethics Committee (IEC No: AIIMS/BBN/IEC/JULY/2022/164), and written and verbal informed consent was obtained from all participants.
Results: Participants highlighted that drones improved acceptability, demand, and integration by reducing travel, enabling timely sputum and medicine delivery, and building community trust. Practicality and implementation were supported by coordination and district authority support, and while stigma, limited payload, weather disruptions, and training gaps were noted, they were viewed as improvable. Peripheral workers were central to community uptake and routine adoption.
Conclusion: Drone-based sputum and medicine transport is operationally feasible and acceptable in rural Indian settings, and participants viewed drones as a promising way to reduce sample transport times and improve access to diagnostics, particularly in hard-to-reach areas. Addressing awareness gaps, stigma, operational barriers, and regulatory delays, while embedding drones into existing health systems, could enable sustainable scale-up and strengthen rural diagnostic networks.
{"title":"Feasibility of drone-based sputum sample and medicine transport for tuberculosis diagnosis in Yadadri-Bhuvanagiri District of Telangana, India: A qualitative study.","authors":"Bhushan Dattatray Kamble, Kuldeep Nigam, Sumit Aggarwal, Meely Panda, Gayatri Potukuchi, Vidya Ganji, Rashmi Kundapur, Neeraj Agarwal, Vikas Bhatia","doi":"10.1177/20552076251406320","DOIUrl":"10.1177/20552076251406320","url":null,"abstract":"<p><strong>Background: </strong>Delays in transporting sputum samples and medicines from peripheral health centers to diagnostic laboratories are a persistent barrier to timely tuberculosis (TB) diagnosis in rural India. Conventional transport methods are often constrained by poor road connectivity, long travel times, and logistical inefficiencies. Unmanned aerial vehicles/drones have shown promise in bridging such gaps in other low-resource and rural areas, yet there is limited evidence on their feasibility, acceptability, and integration within India's National TB Elimination Programme.</p><p><strong>Methods: </strong>In the present qualitative study, 28 in-depth interviews and 12 focus group discussions with 101 purposively selected stakeholders were conducted to understand the feasibility across the five components: acceptability, demand, practicality, implementation, and integration. Data were thematically analyzed using a feasibility framework. Ethical approval was obtained from the Institutional Ethics Committee (IEC No: AIIMS/BBN/IEC/JULY/2022/164), and written and verbal informed consent was obtained from all participants.</p><p><strong>Results: </strong>Participants highlighted that drones improved acceptability, demand, and integration by reducing travel, enabling timely sputum and medicine delivery, and building community trust. Practicality and implementation were supported by coordination and district authority support, and while stigma, limited payload, weather disruptions, and training gaps were noted, they were viewed as improvable. Peripheral workers were central to community uptake and routine adoption.</p><p><strong>Conclusion: </strong>Drone-based sputum and medicine transport is operationally feasible and acceptable in rural Indian settings, and participants viewed drones as a promising way to reduce sample transport times and improve access to diagnostics, particularly in hard-to-reach areas. Addressing awareness gaps, stigma, operational barriers, and regulatory delays, while embedding drones into existing health systems, could enable sustainable scale-up and strengthen rural diagnostic networks.</p>","PeriodicalId":51333,"journal":{"name":"DIGITAL HEALTH","volume":"12 ","pages":"20552076251406320"},"PeriodicalIF":3.3,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12816550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-19eCollection Date: 2026-01-01DOI: 10.1177/20552076251404498
Christina Verma, Jessica Lehane, Monika Janda
Aim: Skin cancer incidence in Australia is among the highest in the world, particularly for outdoor workers, and requires, clear and relevant health promotion resources. Government and non-government organisations across Australia play a key role in providing information and advice on how skin cancer awareness and sun protection advice should be promoted to at-risk population groups like outdoor workers. This study reviewed online resources developed by key organisations around recommended methods for communicating skin cancer awareness and sun protection messages to outdoor workers/outdoor workplaces.
Methods: A rapid desktop review was undertaken in April 2021, focusing on publicly available online resources developed by federal government, state governments and cancer councils and available on websites in Australia. Resources included were selected if they addressed skin cancer, skin cancer prevention, sun safety or sun protection for outdoor workplaces and/or outdoor workers. Selected resources were re-reviewed in November 2024 to compare for changes.
Results: Twenty-five resources were included in this review. Most (19/25) provided advice about how to communicate skin cancer awareness/sun protection messages to outdoor workers, while some did not (4/25). Use of digital technology to reach outdoor workers with sun-safe messages was mentioned in 12/25 resources. These resources mainly encouraged the use of the SunSmart Ultraviolet (UV) mobile application (8/25), specific sun-safety websites (3/25) and/or participation in an online course (2/25). Resources also mentioned non-digital ways of communicating information to outdoor workers.
Conclusion: Digital technology is increasingly being used to communicate skin cancer prevention-related messages to outdoor workers, but non-digital ways are still more common. Increasing awareness about the effectiveness of digital health interventions in skin cancer prevention via online resources is essential for future-proofing sun-safety uptake in contemporary outdoor workplaces.
{"title":"Skin cancer awareness and sun protection advice for outdoor workers in Australia: Review of communication channels to optimise reach and relevance.","authors":"Christina Verma, Jessica Lehane, Monika Janda","doi":"10.1177/20552076251404498","DOIUrl":"10.1177/20552076251404498","url":null,"abstract":"<p><strong>Aim: </strong>Skin cancer incidence in Australia is among the highest in the world, particularly for outdoor workers, and requires, clear and relevant health promotion resources. Government and non-government organisations across Australia play a key role in providing information and advice on how skin cancer awareness and sun protection advice should be promoted to at-risk population groups like outdoor workers. This study reviewed online resources developed by key organisations around recommended methods for communicating skin cancer awareness and sun protection messages to outdoor workers/outdoor workplaces.</p><p><strong>Methods: </strong>A rapid desktop review was undertaken in April 2021, focusing on publicly available online resources developed by federal government, state governments and cancer councils and available on websites in Australia. Resources included were selected if they addressed skin cancer, skin cancer prevention, sun safety or sun protection for outdoor workplaces and/or outdoor workers. Selected resources were re-reviewed in November 2024 to compare for changes.</p><p><strong>Results: </strong>Twenty-five resources were included in this review. Most (19/25) provided advice about how to communicate skin cancer awareness/sun protection messages to outdoor workers, while some did not (4/25). Use of digital technology to reach outdoor workers with sun-safe messages was mentioned in 12/25 resources. These resources mainly encouraged the use of the SunSmart Ultraviolet (UV) mobile application (8/25), specific sun-safety websites (3/25) and/or participation in an online course (2/25). Resources also mentioned non-digital ways of communicating information to outdoor workers.</p><p><strong>Conclusion: </strong>Digital technology is increasingly being used to communicate skin cancer prevention-related messages to outdoor workers, but non-digital ways are still more common. Increasing awareness about the effectiveness of digital health interventions in skin cancer prevention via online resources is essential for future-proofing sun-safety uptake in contemporary outdoor workplaces.</p>","PeriodicalId":51333,"journal":{"name":"DIGITAL HEALTH","volume":"12 ","pages":"20552076251404498"},"PeriodicalIF":3.3,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12816539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-19eCollection Date: 2026-01-01DOI: 10.1177/20552076251412657
Júlia Halamová, Martin Kanovský, Lenka Janík Blašková
Objective: The increasing incidence of compassion fatigue and declining compassion satisfaction among helping professionals underscores the critical need for accessible and empirically supported interventions. Mobile applications represent a viable solution due to their broad accessibility, cost-effectiveness, and scalability.
Methods: The present study examined the effectiveness of the Emotion-Focused Training for Helping Professionals mobile application in targeting multiple dimensions of psychological well-being, including compassion fatigue, compassion satisfaction, resilience, compassion for others, compassion from others, self-compassion, and self-criticism. A total of 190 helping professionals from Slovakia participated in a 14-day intervention, with assessments administered at both baseline and postintervention.
Results: Despite the relatively brief intervention period, participants exhibited statistically significant improvements in compassion satisfaction, resilience, compassion for others, compassion from others, and self-compassion. Additionally, significant decreases were observed in levels of compassion fatigue and self-criticism. These findings provide preliminary support for the application's potential as an effective tool for enhancing psychological resilience and emotional well-being among helping professionals.
Conclusion: To improve the generalizability of these results, future research should examine the intervention's efficacy across culturally and linguistically diverse populations. Moreover, methodological robustness could be strengthened in subsequent studies through the inclusion of control groups and randomized controlled trial designs.
{"title":"Effectiveness of a mobile application the emotion-focused training for helping professionals in reducing compassion fatigue and enhancing compassion satisfaction and resilience.","authors":"Júlia Halamová, Martin Kanovský, Lenka Janík Blašková","doi":"10.1177/20552076251412657","DOIUrl":"10.1177/20552076251412657","url":null,"abstract":"<p><strong>Objective: </strong>The increasing incidence of compassion fatigue and declining compassion satisfaction among helping professionals underscores the critical need for accessible and empirically supported interventions. Mobile applications represent a viable solution due to their broad accessibility, cost-effectiveness, and scalability.</p><p><strong>Methods: </strong>The present study examined the effectiveness of the <i>Emotion-Focused Training for Helping Professionals</i> mobile application in targeting multiple dimensions of psychological well-being, including compassion fatigue, compassion satisfaction, resilience, compassion for others, compassion from others, self-compassion, and self-criticism. A total of 190 helping professionals from Slovakia participated in a 14-day intervention, with assessments administered at both baseline and postintervention.</p><p><strong>Results: </strong>Despite the relatively brief intervention period, participants exhibited statistically significant improvements in compassion satisfaction, resilience, compassion for others, compassion from others, and self-compassion. Additionally, significant decreases were observed in levels of compassion fatigue and self-criticism. These findings provide preliminary support for the application's potential as an effective tool for enhancing psychological resilience and emotional well-being among helping professionals.</p><p><strong>Conclusion: </strong>To improve the generalizability of these results, future research should examine the intervention's efficacy across culturally and linguistically diverse populations. Moreover, methodological robustness could be strengthened in subsequent studies through the inclusion of control groups and randomized controlled trial designs.</p>","PeriodicalId":51333,"journal":{"name":"DIGITAL HEALTH","volume":"12 ","pages":"20552076251412657"},"PeriodicalIF":3.3,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12816538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-19eCollection Date: 2026-01-01DOI: 10.1177/20552076251404509
Anton H van der Vegt, Victoria Campbell, Imogen Mitchell, Oliver C Redfern, Christian Subbe, Roger Conway, Arthas Flabouris, Robin Blythe, Rudolf Schnetler, Christopher Perkins, Naitik Mehta MHServMgt, Ian A Scott
Objective: To compare prediction accuracy of rule-based early warning tools (EWTs) using a large healthcare electronic medical record (EMR) dataset and to re-evaluate using a novel hospital workload capacity evaluation method.
Materials and methods: Adult inpatient admissions to 11 Australian hospitals were included in a retrospective analysis of four EWTs: National Early Warning Score (NEWS), Between the Flags (BTF), Modified Early Warning Score (MEWS) and Queensland Adult Deterioration Detection Systems (Q-ADDS). Using death and unplanned transfer to the intensive care unit (UICU) as composite outcome, each EWT was evaluated with area under the receiver operating curve (AUROC), sensitivity and positive predictive value (PPV). A second analysis was performed with clinician workload capacity indicators.
Results: A total of 683,617 admissions were analysed, including 4954 deaths and 3400 UICU. NEWS2 AUROC was superior to Q-ADDS (1.6%, p < .001), MEWS (3.1%, p < .001) and BTF (28%, p < .001). At each alert threshold, Q-ADDS had superior PPV. Q-ADDS and MEWS operated at the lowest alert burden (1.0-3.8 alerts per 100 patient days) across all alert thresholds [low, moderate and Medical Emergency Team (MET)], followed by NEWS2 (1.9-5.5) and BTF (4.1-18).
Conclusion: Precision-recall workload capacity analysis provides a visual means of displaying the operational characteristics of EWTs in terms of EWT alert thresholds, resultant alert rates and traditional EWT accuracy (PPV and sensitivity). It may be helpful for healthcare organisations to consider clinician workload capacity, in addition to traditional evaluation metrics such as sensitivity and PPV, when selecting EWTs or setting escalation thresholds.
目的:比较基于规则的预警工具(EWTs)使用大型医疗电子病历(EMR)数据集的预测准确性,并使用一种新的医院工作量能力评估方法进行重新评估。材料和方法:对11家澳大利亚医院的成年住院患者进行了四项ewt的回顾性分析:国家预警评分(NEWS)、国旗之间(BTF)、修正预警评分(MEWS)和昆士兰成人恶化检测系统(q -添加)。以死亡和非计划转入重症监护病房(UICU)为复合结局,用受试者工作曲线下面积(AUROC)、敏感性和阳性预测值(PPV)对每个EWT进行评估。对临床医生工作量能力指标进行了第二次分析。结果:共分析入院683,617例,其中死亡4954例,重症监护3400例。NEWS2 AUROC优于q - ads (1.6%, p < 001)、MEWS (3.1%, p < 001)和BTF (28%, p < 001)。在每个警报阈值下,q - add具有更优的PPV。在所有警报阈值[低、中、医疗急救小组(MET)]中,q - add和MEWS的警报负担最低(每100病人日1.0-3.8次警报),其次是NEWS2(1.9-5.5)和BTF(4.1-18)。结论:精确召回工作量能力分析提供了一种可视化的方法,可以显示EWT在EWT警报阈值、由此产生的警报率和传统EWT准确率(PPV和灵敏度)方面的操作特征。在选择ewt或设置升级阈值时,除了传统的评估指标(如敏感性和PPV)外,医疗保健组织考虑临床医生的工作负载能力可能会有所帮助。
{"title":"Using workload capacity indicators to evaluate rule-based early warning tools and their relationship to escalation events.","authors":"Anton H van der Vegt, Victoria Campbell, Imogen Mitchell, Oliver C Redfern, Christian Subbe, Roger Conway, Arthas Flabouris, Robin Blythe, Rudolf Schnetler, Christopher Perkins, Naitik Mehta MHServMgt, Ian A Scott","doi":"10.1177/20552076251404509","DOIUrl":"10.1177/20552076251404509","url":null,"abstract":"<p><strong>Objective: </strong>To compare prediction accuracy of rule-based early warning tools (EWTs) using a large healthcare electronic medical record (EMR) dataset and to re-evaluate using a novel hospital workload capacity evaluation method.</p><p><strong>Materials and methods: </strong>Adult inpatient admissions to 11 Australian hospitals were included in a retrospective analysis of four EWTs: National Early Warning Score (NEWS), Between the Flags (BTF), Modified Early Warning Score (MEWS) and Queensland Adult Deterioration Detection Systems (Q-ADDS). Using death and unplanned transfer to the intensive care unit (UICU) as composite outcome, each EWT was evaluated with area under the receiver operating curve (AUROC), sensitivity and positive predictive value (PPV). A second analysis was performed with clinician workload capacity indicators.</p><p><strong>Results: </strong>A total of 683,617 admissions were analysed, including 4954 deaths and 3400 UICU. NEWS2 AUROC was superior to Q-ADDS (1.6%, <i>p < .</i>001), MEWS (3.1%, <i>p < .</i>001) and BTF (28%, <i>p < .</i>001). At each alert threshold, Q-ADDS had superior PPV. Q-ADDS and MEWS operated at the lowest alert burden (1.0-3.8 alerts per 100 patient days) across all alert thresholds [low, moderate and Medical Emergency Team (MET)], followed by NEWS2 (1.9-5.5) and BTF (4.1-18).</p><p><strong>Conclusion: </strong>Precision-recall workload capacity analysis provides a visual means of displaying the operational characteristics of EWTs in terms of EWT alert thresholds, resultant alert rates and traditional EWT accuracy (PPV and sensitivity). It may be helpful for healthcare organisations to consider clinician workload capacity, in addition to traditional evaluation metrics such as sensitivity and PPV, when selecting EWTs or setting escalation thresholds.</p>","PeriodicalId":51333,"journal":{"name":"DIGITAL HEALTH","volume":"12 ","pages":"20552076251404509"},"PeriodicalIF":3.3,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12819968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146031611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-19eCollection Date: 2026-01-01DOI: 10.1177/20552076251411273
Xi Wang, Fuwen Yang, Julie Trafford, Wuqi Qiu, Cath Conn
In a world increasingly saturated with digital health technologies, the promise of empowerment through information has become almost axiomatic. Yet what if access does not equate to understanding, and what if the sleek interfaces and personalized nudges of today's tools merely simulate agency while displacing it? This presentation interrogates the epistemological and ethical limits of four dominant models underpinning digital health design: the information deficit model, the knowledge-attitude-practice (KAP) framework, health literacy strategies, and behavioral nudging. Despite their differences, each presumes a rational, autonomous user who simply needs the right data or design to act wisely. Drawing on critical public health literature and sociotechnical theory, we argue that these frameworks obscure the structural and social determinants of health (SDoH), such as time poverty, financial stress, and cultural tensions, that fundamentally constrain genuine agency. Rather than merely optimizing individual behavior, this commentary compels the field to confront fundamental questions of power: Who gets to define health? Who designs the algorithm? And who is excluded in the process? By centering these inquiries, the real frontier is not smarter apps, but fairer governance. The paper concludes that addressing the digital divide requires structural interventions, such as participatory oversight and redistributive design, ensuring that digital health systems are grounded in human understanding rather than just administrative efficiency.
{"title":"What counts as care? Structural critique of digital health models.","authors":"Xi Wang, Fuwen Yang, Julie Trafford, Wuqi Qiu, Cath Conn","doi":"10.1177/20552076251411273","DOIUrl":"10.1177/20552076251411273","url":null,"abstract":"<p><p>In a world increasingly saturated with digital health technologies, the promise of empowerment through information has become almost axiomatic. Yet what if access does not equate to understanding, and what if the sleek interfaces and personalized nudges of today's tools merely simulate agency while displacing it? This presentation interrogates the epistemological and ethical limits of four dominant models underpinning digital health design: the information deficit model, the knowledge-attitude-practice (KAP) framework, health literacy strategies, and behavioral nudging. Despite their differences, each presumes a rational, autonomous user who simply needs the right data or design to act wisely. Drawing on critical public health literature and sociotechnical theory, we argue that these frameworks obscure the structural and social determinants of health (SDoH), such as time poverty, financial stress, and cultural tensions, that fundamentally constrain genuine agency. Rather than merely optimizing individual behavior, this commentary compels the field to confront fundamental questions of power: Who gets to define health? Who designs the algorithm? And who is excluded in the process? By centering these inquiries, the real frontier is not smarter apps, but fairer governance. The paper concludes that addressing the digital divide requires structural interventions, such as participatory oversight and redistributive design, ensuring that digital health systems are grounded in human understanding rather than just administrative efficiency.</p>","PeriodicalId":51333,"journal":{"name":"DIGITAL HEALTH","volume":"12 ","pages":"20552076251411273"},"PeriodicalIF":3.3,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12816506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146019977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-19eCollection Date: 2026-01-01DOI: 10.1177/20552076251412044
Sudais Imtiaz, Cheng Yu, Xuewei Chen, Stephen W Pan
Background: Telehealth applications and mobile services have been growing in popularity. As their reach expands service across international boundaries, it remains unclear to what extent Chinese immigrants residing in the United States are using China-based medical applications and the factors impacting their uptake. Although transnational telehealth apps are beneficial in bridging cultural and linguistic gaps, they come with distinct risks and challenges that need to be further explored.
Objectives: The study had three aims: (1) estimate the prevalence of China-based telehealth app usage by Chinese migrants in the US, (2) identify factors associated with China-based telehealth apps utilization among Chinese migrants in the US, and (3) describe how Chinese migrants in the US are using and can use China-based telehealth apps remotely from the US.
Methods: Four focus groups (n = 17) and a cross-sectional survey (n = 227) were conducted among recent Chinese immigrants to the US (arrived in the past 10 years).
Results: Overall, 15% indicated usage of China-based telehealth apps while living within the US. Use of China-based telehealth apps while living in the US was associated with: higher perceived frequency of experiencing healthcare discrimination in the US (odds ratio (OR): 1.43, 95% CI: 1.14-1.80), younger age (OR: 7.86, 95% CI: 1.32-47.01), female sex (OR: 4.29, 95% CI: 1.50-12.23), living in a community with a large Chinese community (OR: 9.53, 95% CI: 1.90-47.79), and lack of medical insurance (OR: 51.59, 95% CI: 3.88-685.70). Some Chinese migrants living in the US are using China-based telehealth apps to consult with medical providers in China as their first line of medical consultation.
Conclusion: Findings suggest uptake of China-based telehealth are partially driven by negative experiences within the US healthcare system. These results are indicative of possible shortcomings in existing healthcare services that diminish the capacity to appropriately address the needs of immigrant communities and groups.
{"title":"Factors associated with transnational telehealth app use among Chinese immigrants in the United States.","authors":"Sudais Imtiaz, Cheng Yu, Xuewei Chen, Stephen W Pan","doi":"10.1177/20552076251412044","DOIUrl":"10.1177/20552076251412044","url":null,"abstract":"<p><strong>Background: </strong>Telehealth applications and mobile services have been growing in popularity. As their reach expands service across international boundaries, it remains unclear to what extent Chinese immigrants residing in the United States are using China-based medical applications and the factors impacting their uptake. Although transnational telehealth apps are beneficial in bridging cultural and linguistic gaps, they come with distinct risks and challenges that need to be further explored.</p><p><strong>Objectives: </strong>The study had three aims: (1) estimate the prevalence of China-based telehealth app usage by Chinese migrants in the US, (2) identify factors associated with China-based telehealth apps utilization among Chinese migrants in the US, and (3) describe how Chinese migrants in the US are using and can use China-based telehealth apps remotely from the US.</p><p><strong>Methods: </strong>Four focus groups (<i>n</i> = 17) and a cross-sectional survey (<i>n</i> = 227) were conducted among recent Chinese immigrants to the US (arrived in the past 10 years).</p><p><strong>Results: </strong>Overall, 15% indicated usage of China-based telehealth apps while living within the US. Use of China-based telehealth apps while living in the US was associated with: higher perceived frequency of experiencing healthcare discrimination in the US (odds ratio (OR): 1.43, 95% CI: 1.14-1.80), younger age (OR: 7.86, 95% CI: 1.32-47.01), female sex (OR: 4.29, 95% CI: 1.50-12.23), living in a community with a large Chinese community (OR: 9.53, 95% CI: 1.90-47.79), and lack of medical insurance (OR: 51.59, 95% CI: 3.88-685.70). Some Chinese migrants living in the US are using China-based telehealth apps to consult with medical providers in China as their first line of medical consultation.</p><p><strong>Conclusion: </strong>Findings suggest uptake of China-based telehealth are partially driven by negative experiences within the US healthcare system. These results are indicative of possible shortcomings in existing healthcare services that diminish the capacity to appropriately address the needs of immigrant communities and groups.</p>","PeriodicalId":51333,"journal":{"name":"DIGITAL HEALTH","volume":"12 ","pages":"20552076251412044"},"PeriodicalIF":3.3,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12816548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-16eCollection Date: 2026-01-01DOI: 10.1177/20552076261415919
Sarah M Hall, David Morin, Joshua B Hall, Alisha H Redelfs
Objectives: Skin cancer represents a significant public health concern, and consistent sunscreen use reduces risk. With social media emerging as a dominant source of health information, unconventional video formats have gained increased prominence. Despite these shifts in health promotion practice, limited research has examined how digital message formats influence health-related beliefs. The objective of this study is to examine how different social media-based message formats (amateur video, professional video, written text, and control) and participant characteristics affect perceptions of skin cancer risk, sunscreen efficacy, and intentions to wear sunscreen to prevent skin cancer.
Methods: A national sample of white US adults (N = 538) were assigned to one of four digital message conditions in an online randomized controlled experiment. Participants completed a fully automated Qualtrics-based survey grounded in the Extended Parallel Process Model (EPPM). EPPM variables, audience perceptions of the message, confidence in identifying signs of skin cancer, and behavioral intentions to wear sunscreen were evaluated through a series of one-way analyses of variance (ANOVAs). Standard multiple regression analysis was used to assess associations between message assignment, demographic characteristics, and EPPM variables.
Results: Both amateur and professionally produced video formats significantly increased participants' beliefs in sunscreen's effectiveness compared to the control condition. The only significant audience perception differences were higher engagement and lower boredom ratings in the professional video condition compared to the amateur video and text-only conditions. Demographic variables including sex, generation, skin sensitivity, and education were significantly associated with differences in perceived threat and efficacy.
Conclusion: Findings indicate that both amateur and professional video-based social media messages can effectively promote sun safety. Public health campaigns aiming to reduce skin cancer risk may be strengthened by incorporating varied digital message formats and tailoring content to key demographic characteristics of the target audience.
{"title":"The role of social media message design and audience demographics in promoting sunscreen use to prevent skin cancer: An online randomized controlled experiment.","authors":"Sarah M Hall, David Morin, Joshua B Hall, Alisha H Redelfs","doi":"10.1177/20552076261415919","DOIUrl":"10.1177/20552076261415919","url":null,"abstract":"<p><strong>Objectives: </strong>Skin cancer represents a significant public health concern, and consistent sunscreen use reduces risk. With social media emerging as a dominant source of health information, unconventional video formats have gained increased prominence. Despite these shifts in health promotion practice, limited research has examined how digital message formats influence health-related beliefs. The objective of this study is to examine how different social media-based message formats (amateur video, professional video, written text, and control) and participant characteristics affect perceptions of skin cancer risk, sunscreen efficacy, and intentions to wear sunscreen to prevent skin cancer.</p><p><strong>Methods: </strong>A national sample of white US adults (<i>N</i> = 538) were assigned to one of four digital message conditions in an online randomized controlled experiment. Participants completed a fully automated Qualtrics-based survey grounded in the Extended Parallel Process Model (EPPM). EPPM variables, audience perceptions of the message, confidence in identifying signs of skin cancer, and behavioral intentions to wear sunscreen were evaluated through a series of one-way analyses of variance (ANOVAs). Standard multiple regression analysis was used to assess associations between message assignment, demographic characteristics, and EPPM variables.</p><p><strong>Results: </strong>Both amateur and professionally produced video formats significantly increased participants' beliefs in sunscreen's effectiveness compared to the control condition. The only significant audience perception differences were higher engagement and lower boredom ratings in the professional video condition compared to the amateur video and text-only conditions. Demographic variables including sex, generation, skin sensitivity, and education were significantly associated with differences in perceived threat and efficacy.</p><p><strong>Conclusion: </strong>Findings indicate that both amateur and professional video-based social media messages can effectively promote sun safety. Public health campaigns aiming to reduce skin cancer risk may be strengthened by incorporating varied digital message formats and tailoring content to key demographic characteristics of the target audience.</p>","PeriodicalId":51333,"journal":{"name":"DIGITAL HEALTH","volume":"12 ","pages":"20552076261415919"},"PeriodicalIF":3.3,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12811576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145999689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-16eCollection Date: 2026-01-01DOI: 10.1177/20552076251413318
Rumanusina Francine Maua, Kelera Oli, Berlin Kafoa, Si Thu Win Tin
Pacific Island Countries and Territories face unique challenges delivering equitable health services due to vast geographic dispersion, limited transport infrastructure, workforce shortages, and increasing climate risks. This article aims to highlight the urgent need for interoperable, standards-based digital health systems in the Pacific and to outline practical pathways for strengthening regional collaboration and resilience. Digital health is not merely a technological upgrade but an essential enabler of health equity and system sustainability. While telehealth and mobile health have gained traction, their full potential is undermined by fragmented, non-interoperable systems that restrict data flows, duplicate effort, and limit impact. Recent progress including national strategies in some Pacific countries and new regional frameworks championed by the Pacific Health Information Network demonstrates growing commitment to shared standards and people-centered solutions. A key pillar for digital health in the Pacific is the need to address language access capabilities thus building multilingual interoperability of systems for clinical safety, equity and effective public-health communication. Practical examples show how shared infrastructure and collaboration strengthen connected care and workforce development across dispersed islands. Achieving this transformation requires strong governance, climate-resilient systems, ethical data protections, and sustained partnerships. Countries, partners, and institutions are called to embed interoperability in national strategies, invest in local capacity, and advance regionally coordinated initiatives such as a Centre of Excellence for Telehealth and Interoperability further promoting language access and multilingual standards for shared health services and workforce. Together, these actions can build a digitally connected health ecosystem that bridges distances, strengthens resilience, and delivers equitable care for all Pacific communities.
{"title":"Strengthening digital health systems in the Pacific: The need for interoperability and innovation.","authors":"Rumanusina Francine Maua, Kelera Oli, Berlin Kafoa, Si Thu Win Tin","doi":"10.1177/20552076251413318","DOIUrl":"10.1177/20552076251413318","url":null,"abstract":"<p><p>Pacific Island Countries and Territories face unique challenges delivering equitable health services due to vast geographic dispersion, limited transport infrastructure, workforce shortages, and increasing climate risks. This article aims to highlight the urgent need for interoperable, standards-based digital health systems in the Pacific and to outline practical pathways for strengthening regional collaboration and resilience. Digital health is not merely a technological upgrade but an essential enabler of health equity and system sustainability. While telehealth and mobile health have gained traction, their full potential is undermined by fragmented, non-interoperable systems that restrict data flows, duplicate effort, and limit impact. Recent progress including national strategies in some Pacific countries and new regional frameworks championed by the Pacific Health Information Network demonstrates growing commitment to shared standards and people-centered solutions<b>.</b> A key pillar for digital health in the Pacific is the need to address language access capabilities thus building multilingual interoperability of systems for clinical safety, equity and effective public-health communication. Practical examples show how shared infrastructure and collaboration strengthen connected care and workforce development across dispersed islands. Achieving this transformation requires strong governance, climate-resilient systems, ethical data protections, and sustained partnerships. Countries, partners, and institutions are called to embed interoperability in national strategies, invest in local capacity, and advance regionally coordinated initiatives such as a Centre of Excellence for Telehealth and Interoperability further promoting language access and multilingual standards for shared health services and workforce. Together, these actions can build a digitally connected health ecosystem that bridges distances, strengthens resilience, and delivers equitable care for all Pacific communities.</p>","PeriodicalId":51333,"journal":{"name":"DIGITAL HEALTH","volume":"12 ","pages":"20552076251413318"},"PeriodicalIF":3.3,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12811551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145999711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-16eCollection Date: 2026-01-01DOI: 10.1177/20552076261415929
Siyu Qian, Jiachen Gu, Haonan Zhao
Objective: This cross-sectional study aimed to analyze the content and quality of migraine-related videos on Chinese video-sharing platforms.
Background: In recent years, the escalating incidence and prevalence of migraine have imposed an increasing burden on individuals. Short-video platforms, such as TikTok and BiliBili, have demonstrated immense potential for disseminating health-related information. While a substantial number of migraine-specific videos are available on TikTok and BiliBili, their quality and reliability remain largely uncharacterized.
Method: On 24 August 2025, short videos related to migraine were gathered from BiliBili and TikTok via a comprehensive Chinese language search. Following the extraction of fundamental information, each video was evaluated using the Global Quality Score (GQS), the modified DISCERN tool (mDISCERN) score, and the Patient Education Materials Assessment Tool (PEMAT). Furthermore, Spearman's correlation analysis was employed to investigate the relationships among video variables, GQS, DISCERN, and PEMAT scores.
Results: TikTok demonstrated greater popularity than BiliBili, evidenced by higher numbers of likes, collections, comments, and shares. Overall, short videos on TikTok generally received superior scores across all evaluation metrics compared to those on BiliBili. Furthermore, it was observed that videos shared by Neurology Professionals consistently scored higher in GQS, mDISCERN, PEMAT-U, and PEMAT-A than those from other contributors. Spearman's correlation analysis indicated no significant association between video variables and GQS or mDISCERN scores.
Conclusions: The quality and reliability of migraine-related videos on both BiliBili and TikTok were found to be suboptimal. Notably, videos shared by Neurology Professionals tended to exhibit superior quality and trustworthiness. Therefore, individuals should exercise caution when consuming short-form video content.
{"title":"The quality and reliability of short videos about migraine on Chinese social Media platforms (BiliBili and TikTok): A cross-sectional study.","authors":"Siyu Qian, Jiachen Gu, Haonan Zhao","doi":"10.1177/20552076261415929","DOIUrl":"10.1177/20552076261415929","url":null,"abstract":"<p><strong>Objective: </strong>This cross-sectional study aimed to analyze the content and quality of migraine-related videos on Chinese video-sharing platforms.</p><p><strong>Background: </strong>In recent years, the escalating incidence and prevalence of migraine have imposed an increasing burden on individuals. Short-video platforms, such as TikTok and BiliBili, have demonstrated immense potential for disseminating health-related information. While a substantial number of migraine-specific videos are available on TikTok and BiliBili, their quality and reliability remain largely uncharacterized.</p><p><strong>Method: </strong>On 24 August 2025, short videos related to migraine were gathered from BiliBili and TikTok via a comprehensive Chinese language search. Following the extraction of fundamental information, each video was evaluated using the Global Quality Score (GQS), the modified DISCERN tool (mDISCERN) score, and the Patient Education Materials Assessment Tool (PEMAT). Furthermore, Spearman's correlation analysis was employed to investigate the relationships among video variables, GQS, DISCERN, and PEMAT scores.</p><p><strong>Results: </strong>TikTok demonstrated greater popularity than BiliBili, evidenced by higher numbers of likes, collections, comments, and shares. Overall, short videos on TikTok generally received superior scores across all evaluation metrics compared to those on BiliBili. Furthermore, it was observed that videos shared by Neurology Professionals consistently scored higher in GQS, mDISCERN, PEMAT-U, and PEMAT-A than those from other contributors. Spearman's correlation analysis indicated no significant association between video variables and GQS or mDISCERN scores.</p><p><strong>Conclusions: </strong>The quality and reliability of migraine-related videos on both BiliBili and TikTok were found to be suboptimal. Notably, videos shared by Neurology Professionals tended to exhibit superior quality and trustworthiness. Therefore, individuals should exercise caution when consuming short-form video content.</p>","PeriodicalId":51333,"journal":{"name":"DIGITAL HEALTH","volume":"12 ","pages":"20552076261415929"},"PeriodicalIF":3.3,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12811590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145999728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-16eCollection Date: 2026-01-01DOI: 10.1177/20552076261416808
San-Ping Wang, Yun-Ling Liu
{"title":"Artificial intelligence in occupational therapy documentation: Chatbot versus Occupational Therapists: A Letter to the Editor.","authors":"San-Ping Wang, Yun-Ling Liu","doi":"10.1177/20552076261416808","DOIUrl":"10.1177/20552076261416808","url":null,"abstract":"","PeriodicalId":51333,"journal":{"name":"DIGITAL HEALTH","volume":"12 ","pages":"20552076261416808"},"PeriodicalIF":3.3,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12811553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145999734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}