ATOM Calibration Framework: Interaction and Visualization Functionalities

Robotic systems are evolving to include a large number of sensors and diverse sensor modalities. In order to operate a system with multiple sensors, the geometric transformations between those sensors must be accurately estimated. The process by which these transformations are estimated is known as sensor calibration. Behind every sensor calibration approach is a formulation and a framework. The formulation is the method by which the transformations are estimated. The framework is the set of operations required to carry out the calibration procedure. This paper proposes a novel calibration framework that gives more flexibility, control and information to the user, enhancing the user interface and the user experience of calibrating a robotic system. The framework consists of several visualization and interaction functionalities useful for a calibration procedure, such as the estimation of the initial pose of the sensors, the data collection and labeling, the data review and correction and the visualization of the estimation of the extrinsic and intrinsic parameters. This framework is supported by the Atomic Transformations Optimization Method formulation, referred to as ATOM. Results show that this framework is applicable to various robotic systems with different configurations, number of sensors and sensor modalities. In addition to this, a survey comparing the frameworks of different calibration approaches shows that ATOM provides a very good user experience.

User-Centered Design to Reduce Inappropriate Blood Transfusion Orders

BACKGROUND

To improve blood transfusion practices, we applied user-centered design (UCD) to evaluate potential changes to blood transfusion orders.

OBJECTIVES

The aim of the study is to build effective transfusion orders with different designs to improve guideline adherence.

METHODS

We developed three different versions of transfusion orders that varied how information was presented to clinicians ordering blood transfusions. We engaged 14 clinicians (residents, advanced practice providers [APPs], and attending physicians) from different specialties. We used the think aloud technique and rapid qualitative analysis to generate themes to incorporate into our modified orders.

RESULTS

Most end-users who participated in the semi-structured interviews preferred the interruptive alert design plus behavioral nudges (n = 8/14, 57%). The predominant rationale was that the in-line alert was not visually effective in capturing the end-user's attention, while the interruptive alert forced a brief stop in the workflow to consider the guidelines. All users supported the general improvements, though for different reasons, and as a result, the general improvements remained in the designs for the forthcoming trial.

CONCLUSION

The user experience uncovered through the think aloud approach produced a clear and rich understanding of potentially confounding factors in the initial design of different intervention versions. Input from end-users guided the creation of all three designs so each was addressing human factors with parity, which ensured that the results of our study reflected differences in interruptive properties of the alerts and not differences in design.

Moderated digital social therapy for young people with emerging mental health problems: A user-centered mixed-method design and usability study

Introduction

Over 25% of Dutch young people are psychologically unhealthy. Individual and societal consequences that follow from having mental health complaints at this age are substantial. Young people need care which is often unavailable. ENgage YOung people earlY (ENYOY) is a moderated digital social therapy-platform that aims to help youngsters with emerging mental health complaints. Comprehensive research is being conducted into the effects and to optimize and implement the ENYOY-platform throughout the Netherlands. The aim of this study is to explore the usability and user experience of the ENYOY-platform.

Methods

A user-centered mixed-method design was chosen. 26 young people aged 16-25 with emerging mental health complaints participated. Semi-structured interviews were conducted to explore usability, user-friendliness, impact, accessibility, inclusivity, and connection (Phase 1). Phase 2 assessed usability problems using the concurrent and retrospective Think Aloud-method. User experience and perceived helpfulness were assessed using a 10-point rating scale and semi-structured interviews (Phase 3). The Health Information Technology Usability Evaluation Scale (Health-ITUES; Phase 1) and System Usability Scale (SUS; Phase 2 and 3) were administered. Qualitative data was analyzed using thematic analysis. Task completion rate and time were tracked and usability problems were categorized using the Nielsen's rating scale (Phase 2).

Results

Adequate to high usability was found (Phase 1 Health-ITUES 4.0(0.34); Phase 2 SUS 69,5(13,70); Phase 3 SUS 71,6(5,63)). Findings from Phase 1 (N = 10) indicated that users viewed ENYOY as a user-friendly, safe, accessible, and inclusive initiative which helped them reduce their mental health complaints and improve quality of life. Phase 2 (N = 10) uncovered 18 usability problems of which 5 of major severity (e.g. troubles accessing the platform). Findings from Phase 3 (N = 6) suggested that users perceived the coaching calls the most helpful [9(0.71)] followed by the therapy content [6.25(1.41)]. Users liked the social networking aspect but rated it least helpful [6(2.1)] due to inactivity.

Conclusion

The ENYOY-platform has been found to have adequate to high usability and positive user experiences were reported. All findings will be transferred to the developmental team to improve the platform. Other evaluation methods and paring these with quantitative outcomes could provide additional insight in future research.

Adolescents' Assessment of Two Mental Health-Promoting Mobile Apps: Results of Two User Surveys

BACKGROUND

The importance of mental health promotion is irrevocable and is especially important at a young age. More mental health-promoting mobile apps have been developed in the last few years. However, their usability and quality have been rarely assessed.

OBJECTIVE

The aim of this study is to investigate how adolescents assess the usability, quality, and potential goal achievement of Opp and NettOpp. Opp is a universal mental health-promoting mobile app aimed at 13- to 19-year-olds, and NettOpp is a mobile app for children and adolescents between 11 to 16 years of age that have experienced negative incidents online.

METHODS

A total of 45 adolescents tested either Opp (n=30) or NettOpp (n=15) for a period of 3 weeks and answered a questionnaire. The System Usability Scale (SUS) was used to measure the usability of the apps. A SUS score above 70 indicates acceptable usability. Items from the Mobile Application Rating Scale were adapted for study purposes and used to measure the quality and perceived goal achievement that Opp and NettOpp might have on adolescents' knowledge, attitudes, and intention to change behavior. Furthermore, adolescents could answer an open comment question.

RESULTS

Opp had a mean SUS score of 80.37 (SD 9.27), and NettOpp's mean SUS score was 80.33 (SD 10.30). In the overall evaluation, Opp and NettOpp were given a mean score of 3.78 (SD 0.42) and 4.20 (SD 0.56), respectively, on a 5-point scale, where 5 was best. Most adolescents who evaluated Opp rated that the app would increase knowledge about mental health and help young people deal with stress and difficult emotions or situations. Most adolescents who evaluated NettOpp agreed that the app would increase awareness and knowledge about cyberbullying, change attitudes toward cyberbullying, and motivate them to address cyberbullying. Some adolescents stated that Opp was difficult to navigate and consisted of too much text. Some of the adolescents that tested NettOpp stated that the app had crashed and that the design was a bit childish.

CONCLUSIONS

All in all, this study indicates that Opp and NettOpp have good usability and that adolescents are satisfied with both apps. It also indicates that the potential goal achievement of the apps, for example, increasing knowledge about mental health (Opp) or cyberbullying (NettOpp) is promising. While there are some comments from the users that are more difficult to solve (eg, Opp is too text-based), some comments helped improve the apps (eg, that the app crashed). Overall, the user evaluation provided valuable knowledge about how adolescents assess Opp and NettOpp. However, more extensive effectiveness studies are necessary to measure their actual goal achievement.

Graduating nursing students' user experiences of the immersive virtual reality simulation in learning - A qualitative descriptive study

AIM

To describe nursing students' user experiences' (UX) regarding highly immersive virtual reality (VR) simulation with head mounted display used for learning.

DESIGN

Qualitative descriptive study.

METHODS

Graduating nursing students (n = 41). Individual interviews were held right after VR simulation. The usability was assessed using System Usability Scale (SUS).

RESULTS

User experiences emphasized three themes about the highly immersive VR simulation: nursing care in the immersive VR simulation, technology in the immersive VR simulation, and learning nursing in the immersive VR simulation. Usability was evaluated as fair (SUS score 62.3 out of 100). Scores revealed that the VR simulation was easy to use. The support of a technical person was highlighted.

CONCLUSIONS

This study supports strongly the use of highly immersive VR simulation for nursing education. VR simulations should replicate the most authentic nursing care. Technical assistance is crucial when adopting new technologies in education. The results highlighted the importance of UX in an education context.

Research on the brand image of iOS and Android smart phone operating systems based on mixed methods

Introduction

To analyze the differences in system functions, interaction behaviors and user experience between iOS and Android smart phone operating system, and then study the differences in their brand images, so as to provide theory and research method for shaping corporate brand images from the perspective of product interaction design.

Methods

This study was divided into three stages. In the first stage, the functional information architecture of iOS and Android smart phone operating system are studied comparatively by using information visualization methods. In the second stage, the brand image differences between the two systems at the explicit, behavioral and semantic levels are analyzed comparatively by building the "explicit - behavioral - semantic" product brand gene model. In the third stage, the functions of "setting alarm clock", "sharing pictures" and "modifying passwords" were selected for interactive behavior analysis. First, analyze the user experience of the three system functions from the perspective of interaction process and information architecture, and present the analysis results using the method of information visualization.; Secondly, the user experience and brand image differences between the two systems are analyzed by setting up manipulation task experiments.

Results

The brand images of iOS and Android systems are similar in conciseness, clearness and efficiency; In terms of uniqueness, iOS system is more unique, while Android system has stronger applicability.

Discussion

This study constructs an "explicit-behavior-semantic" brand gene model to create a unique product brand image for software products such as operating systems through interactive design, so as to solve the problem of product brand image homogeneity caused by the convergence of function and interaction design.

Development of a video-based evidence synthesis knowledge translation resource: Drawing on a user-centred design approach

Objectives

We aimed to develop a video animation knowledge translation (KT) resource to explain the purpose, use and importance of evidence synthesis to the public regarding healthcare decision-making.

Methods

We drew on a user-centred design approach to develop a spoken animated video (SAV) by conducting two cycles of idea generation, prototyping, user testing, analysis, and refinement. Six researchers identified the initial key messages of the SAV and informed the first draft of the storyboard and script. Seven members of the public provided input on this draft and the key messages through think-aloud interviews, which we used to develop an SAV prototype. Seven additional members of the public participated in think-aloud interviews while watching the video prototype. All members of the public also completed a questionnaire on perceived usefulness, desirability, clarity and credibility. We subsequently synthesised all data to develop the final SAV.

Results

Researchers identified the initial key messages as 1) the importance of evidence synthesis, 2) what an evidence synthesis is and 3) how evidence synthesis can impact healthcare decision-making. Members of the public rated the initial video prototype as 9/10 for usefulness, 8/10 for desirability, 8/10 for clarity and 9/10 for credibility. Using their guidance and feedback, we produced a three-and-a-half-minute video animation. The video was uploaded on YouTube, has since been translated into two languages, and viewed over 12,000 times to date.

Conclusions

Drawing on user-centred design methods provided a structured and transparent approach to the development of our SAV. Involving members of the public enhanced the credibility and usefulness of the resource. Future work could explore involving the public from the outset to identify key messages in developing KT resources explaining methodological topics. This study describes the systematic development of a KT resource with limited resources and provides transferrable learnings for others wishing to do similar.

How does platform's fintech level affect its word of mouth from the perspective of user psychology?

Introduction

The rapid development of fintech has brought opportunities for business operations and economic development. Currently, few researches have focused on how fintech level affects word-of-mouth (WOM) from the perspective of user psychology. Therefore, studying the effect of fintech level on WOM is a worthwhile scientific question.

Methods

Based on motivation theory and reinforcement theory, this paper proposes a new psychology-based theoretical framework model to study the relationship between fintech level and WOM and constructs a structural equation model including fintech level, user experience, user trust, user stickiness and WOM through the analysis of 732 questionnaires.

Results

The results indicate that the improvement of fintech level can enhance WOM. More specifically, fintech level has a significantly positive influence on user stickiness through two mediation variables (user experience and user trust), and further, user stickiness has a significantly positive influence on WOM.

Discussion

This paper analyzes the internal mechanism of fintech level's influence on WOM from the micro psychological perspective, which enriches the psychology theoretical research. And, the conclusions provide specific suggestions for marketing and promotion of financial platforms in the future.

HomeCoRe system for telerehabilitation in individuals at risk of dementia: A usability and user experience study

Background

Telerehabilitation has enabled a broader application of cognitive rehabilitation programs. We have recently developed HomeCoRe, a system for supporting cognitive intervention remotely with the assistance of a family member. The main goal of the present study was to determine usability and user experience of HomeCoRe in individuals at risk of dementia and in their family members. The association between subjects' technological skills and main outcome measures was evaluated as well.

Methods

Fourteen individuals with subjective cognitive decline (SCD) or mild neurocognitive disorder (mNCD) were recruited to participate in this pilot study. All participants received a touch-screen laptop implemented with the HomeCoRe software. The intervention consisted of 18 sessions and included a patient-tailored adaptive protocol of cognitive exercises. Usability was assessed in terms of treatment adherence and participants' performance across sessions; user experience via self-reported questionnaires and a descriptive diary.

Results

Usability and user experience were overall satisfactory and suggested usability, pleasantness, and high motivation while using HomeCoRe. Technological skills correlated only with the perceived ability to start and/or perform exercises autonomously.

Discussion

These results, although preliminary, suggest that the usability and user experience of HomeCoRe are satisfactory and independent of technological skills. These findings encourage wider and more systematic use of HomeCoRe to overcome the current limitations of in-person cognitive rehabilitation programs and to reach more individuals at risk of dementia.

Robotic gaze and human views: A systematic exploration of robotic gaze aversion and its effects on human behaviors and attitudes

Similar to human-human interaction (HHI), gaze is an important modality in conversational human-robot interaction (HRI) settings. Previously, human-inspired gaze parameters have been used to implement gaze behavior for humanoid robots in conversational settings and improve user experience (UX). Other robotic gaze implementations disregard social aspects of gaze behavior and pursue a technical goal (e.g., face tracking). However, it is unclear how deviating from human-inspired gaze parameters affects the UX. In this study, we use eye-tracking, interaction duration, and self-reported attitudinal measures to study the impact of non-human inspired gaze timings on the UX of the participants in a conversational setting. We show the results for systematically varying the gaze aversion ratio (GAR) of a humanoid robot over a broad parameter range from almost always gazing at the human conversation partner to almost always averting the gaze. The main results reveal that on a behavioral level, a low GAR leads to shorter interaction durations and that human participants change their GAR to mimic the robot. However, they do not copy the robotic gaze behavior strictly. Additionally, in the lowest gaze aversion setting, participants do not gaze back as much as expected, which indicates a user aversion to the robot gaze behavior. However, participants do not report different attitudes toward the robot for different GARs during the interaction. In summary, the urge of humans in conversational settings with a humanoid robot to adapt to the perceived GAR is stronger than the urge of intimacy regulation through gaze aversion, and a high mutual gaze is not always a sign of high comfort, as suggested earlier. This result can be used as a justification to deviate from human-inspired gaze parameters when necessary for specific robot behavior implementations.

Resuscitators' opinions on using a respiratory function monitor during neonatal resuscitation

AIM

The aim of this study was to assess the resuscitators' opinions of the usefulness and clinical value of using a respiratory function monitor (RFM) when resuscitating extremely preterm infants with positive pressure ventilation.

METHODS

The link to an online survey was sent to 106 resuscitators from six countries who were involved in a multicentre trial that compared the percentage of inflations within a predefined target range with and without the RFM. The resuscitators were asked to assess the usefulness and clinical value of the RFM. The survey was online for 4 months after the trial ended in May 2019.

RESULTS

The survey was completed by 74 (70%) resuscitators of which 99% considered the RFM to be helpful during neonatal resuscitation and 92% indicated that it influenced their decision-making. The majority (76%) indicated that using the RFM improved their practice and made resuscitation more effective, even when the RFM was not available. Inadequate training was the key issue that limited the effectiveness of the RFM: 45% felt insufficiently trained, and 78% felt more training in using and interpreting the RFM would have been beneficial.

CONCLUSION

Resuscitators considered the RFM to be helpful to guide neonatal resuscitation, but sufficient training was required to achieve the maximum benefit.

Facilitating engagement of universal school-based digital mental health solutions through user experience: A qualitative exploration

Digital mental health intervention (DMHI) programs offered in schools present a readily-accessible and flexible means for educating, empowering, and supporting adolescents in maintaining a balanced mental health, especially during uncertain and stressful times such as the COVID-19 pandemic. Recent studies indicate that the effectiveness of DMHI programs in improving students' mental well-being and in preventing from their mental health complications depends on the users' engagement. This study focuses on identifying the user experience factors that can facilitate user engagement with universal school-based DMHI programs (i.e., the DMHI programs delivered to the students regardless of their mental health risks or conditions). To identify said factors, we sought to gain a deeper understanding of perceptions, opinions, and preferences of actual end-users (i.e., the adolescents) regarding their experiences with both digital and non-digital mental health resources. Specifically, interviews were conducted with two participant groups to uncover the reasons that could lead the adolescents to better engage with school-based DMHI programs, as well as the shortcomings that could prevent that from happening: (a) adolescent users who had either a high or a low level of engagement with universal DMHI programs of a specific school-based digital mental health solution; and (b) adolescents who had voluntarily used non-digital or non-school-based digital mental health resources for purposes other than treatment. Through a thematic analysis of interview data, the most important (or primary) and the additionally desirable (or secondary) factors that could lead to a higher engagement level for school-based DMHI programs were identified. Lastly, using the evidence gathered from our interviews, specific recommendations are proposed that could help in targeting each identified engagement factor and in increasing the likelihood that school-based DMHI programs achieve their desired outcome for high school students.

A Training Smartphone Application for the Simulation of Outdoor Blind Pedestrian Navigation: Usability, UX Evaluation, Sentiment Analysis

Training blind and visually impaired individuals is an important but often neglected aspect of Assistive Technology solutions (ATs) that can benefit from systems utilizing multiple sensors and hardware devices. Training serves a dual purpose as it not only enables the target group to effectively utilize the ATs but, also, helps in improving their low acceptance rate. In this paper, we present the design, implementation, and validation of a smartphone-based training application. It is a form of immersive system that enables users to learn the features of an outdoor blind pedestrian navigation application and, simultaneously, to help them develop long-term Orientation and Mobility (O&M) skills. The system consists of an Android application leveraging, as data sources, an external high-accuracy GPS sensor for real-time pedestrian mobility tracking, a second custom-made device attached to traffic lights for identifying their status, and an ultra-sonic sensor for detecting near-field obstacles on the navigation path of the users. The training version running as an Android application employs route simulation with audio and haptic feedback, is functionally equivalent to the main application, and was used in the context of specially designed user-centered training sessions. A Usability and User Experience (UX) evaluation revealed the positive attitude of the users towards the training version as well as their satisfaction with the skills acquired during their training sessions (SUS = 69.1, UEQ+ = 1.53). Further confirming the positive attitude was the conduct of a Recursive Neural Network (RNN)-based sentiment analysis on user responses with a score of 3 on a scale from 0 to 4. Finally, we conclude with the lessons learned and the proposal of general design guidelines concerning the observed lack of accessibility and non-universal interfaces.

User Experience of COVID-19 Chatbots: Scoping Review

BACKGROUND

The COVID-19 pandemic has had global impacts and caused some health systems to experience substantial pressure. The need for accurate health information has been felt widely. Chatbots have great potential to reach people with authoritative information, and a number of chatbots have been quickly developed to disseminate information about COVID-19. However, little is known about user experiences of and perspectives on these tools.

OBJECTIVE

This study aimed to describe what is known about the user experience and user uptake of COVID-19 chatbots.

METHODS

A scoping review was carried out in June 2021 using keywords to cover the literature concerning chatbots, user engagement, and COVID-19. The search strategy included databases covering health, communication, marketing, and the COVID-19 pandemic specifically, including MEDLINE Ovid, Embase, CINAHL, ACM Digital Library, Emerald, and EBSCO. Studies that assessed the design, marketing, and user features of COVID-19 chatbots or those that explored user perspectives and experience were included. We excluded papers that were not related to COVID-19; did not include any reporting on user perspectives, experience, or the general use of chatbot features or marketing; or where a version was not available in English. The authors independently screened results for inclusion, using both backward and forward citation checking of the included papers. A thematic analysis was carried out with the included papers.

RESULTS

A total of 517 papers were sourced from the literature, and 10 were included in the final review. Our scoping review identified a number of factors impacting adoption and engagement including content, trust, digital ability, and acceptability. The papers included discussions about chatbots developed for COVID-19 screening and general COVID-19 information, as well as studies investigating user perceptions and opinions on COVID-19 chatbots.

CONCLUSIONS

The COVID-19 pandemic presented a unique and specific challenge for digital health interventions. Design and implementation were required at a rapid speed as digital health service adoption accelerated globally. Chatbots for COVID-19 have been developed quickly as the pandemic has challenged health systems. There is a need for more comprehensive and routine reporting of factors impacting adoption and engagement. This paper has shown both the potential of chatbots to reach users in an emergency and the need to better understand how users engage and what they want.

Defining a Role for Webinars in Surgical Training Beyond the COVID-19 Pandemic in the United Kingdom: Trainee Consensus Qualitative Study

BACKGROUND

The COVID-19 pandemic posed several challenges for surgical training, including the suspension of many in-person teaching sessions in lieu of webinars. As restrictions have eased, both prepandemic and postpandemic training methods should be used.

OBJECTIVE

This study investigates trainees' experiences of webinars during the COVID-19 pandemic to develop recommendations for their effective integration into surgical training going forward.

METHODS

This project was led by the Association of Surgeons in Training and used an iterative process with mixed qualitative methods to consolidate arguments for and against webinars, and the drivers and barriers to their effective delivery, into recommendations. This involved 3 phases: (1) a web-based survey, (2) focus group interviews, and (3) a consensus session using a nominal group technique.

RESULTS

Trainees (N=281) from across specialties and grades confirmed that the COVID-19 pandemic led to an increase in webinars for surgical training. While there were concerns, particularly around the utility for practical training (80.9%), the majority agreed that webinars had a role in training following the COVID-19 pandemic (90.2%). The cited benefits included improved access or flexibility and potential standardization of training. The majority of limitations were technical. These perspectives were refined through focus group interviews (n=18) into 25 recommendations, 23 of which were ratified at a consensus meeting, which was held at the Association of Surgeons in Training 2021 conference.

CONCLUSIONS

Webinars have a role in surgical training following the COVID-19 pandemic. The 23 recommendations encompass indications and technical considerations but also discuss important knowledge gaps. They should serve as an initial framework for ensuring that webinars add value and continue to evolve as a tool for training.

TRIAL REGISTRATION

Chinese Clinical Trial Registry ChiCTR2200055325; http://www.chictr.org.cn/showprojen.aspx?proj=142802.

Analysis of Patient Cues in Asynchronous Health Interactions: Pilot Study Combining Empathy Appraisal and Systemic Functional Linguistics

BACKGROUND

Lifestyle-related diseases are among the leading causes of death and disability. Their rapid increase worldwide has called for low-cost, scalable solutions to promote health behavior changes. Digital health coaching has proved to be effective in delivering affordable, scalable programs to support lifestyle change. This approach increasingly relies on asynchronous text-based interventions to motivate and support behavior change. Although we know that empathy is a core element for a successful coach-user relationship and positive patient outcomes, we lack research on how this is realized in text-based interactions. Systemic functional linguistics (SFL) is a linguistic theory that may support the identification of empathy opportunities (EOs) in text-based interactions, as well as the reasoning behind patients' linguistic choices in their formulation.

OBJECTIVE

This study aims to determine whether empathy and SFL approaches correspond and complement each other satisfactorily to study text-based communication in a health coaching context. We sought to explore whether combining empathic assessment with SFL categories can provide a means to understand client-coach interactions in asynchronous text-based coaching interactions.

METHODS

We retrieved 148 text messages sent by 29 women who participated in a randomized trial of telecoaching for the prevention of gestational diabetes mellitus (GDM) and postnatal weight loss. We conducted a pilot study to identify users' explicit and implicit EOs and further investigated these statements using the SFL approach, focusing on the analysis of transitivity and thematic analysis.

RESULTS

We identified 164 EOs present in 42.37% (3478/8209) of the word count in the corpus. These were mainly negative (n=90, 54.88%) and implicit (n=55, 60.00%). We distinguished opening, content and closing messages structures. Most of the wording was found in the content (n=7077, 86.21%) with a declarative structure (n=7084, 86.30%). Processes represented 22.4% (n=1839) of the corpus, with half being material (n=876, 10.67%) and mostly related to food and diet (n=196, 54.92%), physical activity (n=96, 26.89%), and lifestyle goals (n=40, 11.20%).

CONCLUSIONS

Our findings show that empathy and SFL approaches are compatible. The results from our transitivity analysis reveal novel insights into the meanings of the users' EOs, such as their seek for help or praise, often missed by health care professionals (HCPs), and on the coach-user relationship. The absence of explicit EOs and direct questions could be attributed to low trust on or information about the coach's abilities. In the future, we will conduct further research to explore additional linguistic features and code coach messages.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12620001240932; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380020.

Experiences of Patients and Therapists Testing a Virtual Reality Exposure App for Symptoms of Claustrophobia: Mixed Methods Study

BACKGROUND

The effectiveness of virtual reality exposure (VRE) in the treatment of anxiety disorders is well established. Several psychological mechanisms of VRE have been identified, whereby both emotional processing and the sense of presence play a key role. However, there are only few studies that contribute to our knowledge of examples of implementation in the case of VRE for claustrophobia based on patients' experiences and the perspective of therapists.

OBJECTIVE

This study asks for key elements of a VRE app that are necessary for effective exposure for people with claustrophobic symptoms.

METHODS

A mixed methods design was applied in which patients (n=15) and therapeutic experts (n=15) tested a VRE intervention of an elevator ride at 5 intensity levels. Intensity was varied by elevator size, duration of the elevator ride, and presence of virtual humans. Quantitative measures examined self-reported presence with the Igroup Presence Questionnaire (IPQ) ranging from 0 to 6 and 15 Likert-scaled evaluation items that had been developed for the purpose of this study, ranging from 1 to 5. In both measures, higher scores indicate higher levels of presence or agreement. Think-aloud protocols of the patients and semistructured interviews posttreatment of all participants were conducted to gain in-depth perspectives on emotional processes.

RESULTS

The intervention induced a feeling of presence in patients and experts, posttreatment scores showed a high IPQ presence score (mean 3.84, SD 0.88), with its subscores IPQ spatial presence (mean 4.53, SD 1.06), IPQ involvement (mean 3.83, SD 1.22), and IPQ experienced realism (mean 2.75, SD 1.02). Patients preferred a setting in the presence of a therapist (mean 4.13, SD 0.83) more than the experts did (mean 3.33, SD 1.54). Think-aloud protocols of the patients revealed that presence and anxiety both were achieved. Qualitative interviews of patients and experts uncovered 8 topics: feelings and emotions, personal story, telepresence, potential therapeutic effects, barriers, conditions and requirements, future prospects, and realization. The intensity levels were felt to appropriately increase in challenge, with ambivalent results regarding the final level. Virtual humans contributed to feelings of fear.

CONCLUSIONS

Key elements of a VRE app for claustrophobic symptoms should include variation of intensity by adding challenging cues in order to evoke presence and anxiety. Virtual humans are a suitable possibility to make the intervention realistic and to provide a sense of closeness; however, some of the fears might then be related to symptoms of social phobia or agoraphobia. Patients may need the physical presence of a therapist, though not all of them share this view. A higher degree of sophistication in the intensity levels is needed to deliver targeted help for specific symptoms of anxiety.

Online Store Aesthetics Impact Efficacy of Product Recommendations and Highlighting

Owing to high competition in e-commerce, customers may prefer sites that ensure that good user experience (UX) and website aesthetics are one of its qualities. The method of presenting items seems crucial for gaining and maintaining user attention. We conducted a task-based user eye-tracking study with n = 30 participants to examine two variants of an online fashion store: one based on aesthetic rules and one defying them. The following aspects of item presentation were considered: height and width the ratio of product photos, website colors, rounded borders, text visibility, spacing between elements, and smooth animation. We investigated their relationship to user attention by analyzing gaze fixation, tracking user interest, and conducting a supplementary survey. Experimental results showed that owing to following the rules of aesthetics in interface design in the presented fashion shopping scenario, elements such as the recommendation area and product highlights had a significant positive impact on customer attention.

Industrial exoskeletons from bench to field: Human-machine interface and user experience in occupational settings and tasks

Objective

Work-related musculoskeletal disorders (WRMSDs) are considered nowadays the most serious issue in the Occupational Health and Safety field and industrial exoskeletons appear to be a new approach to addressing this medical burden. A systematic review has been carried out to analyze the real-life data of the application of exoskeletons in work settings considering the subjective responses of workers.

Methods

The review was registered on PROSPERO. The literature search and its report have been performed following the PRISMA guidelines. A comprehensive literature search was performed in PubMed, EMBASE, Web of Science, and Scopus.

Results

Twenty-four original studies were included in the literature review; 42% of the papers retrieved included automobilist industry workers, 17% of the studies evaluated the use of exoskeletons in logistic facilities, and 17% of articles involved healthcare. The remaining six papers recruited farmers, plasterers, wasting collectors, construction workers, and other workmen. All the papers selected tested the use of passive exoskeletons, supporting upper arms or back. Usability, perceived comfort, perceived exertion and fatigue, acceptability and intention to use, occupational safety and health, and job performance and productivity were the main topic analyzed.

Conclusion

Exoskeletons are not a fix-all technology, neither for workers nor for job tasks; they tend to show more of their potential in static activities, while in dynamic tasks, they can obstacle regular job performance. Comfort and easiness of use are the key factors influencing the user's experience. More research is needed to determine the most effective and safe ways to implement exoskeleton use in occupational settings.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=275728, identifier CRD42021275728.

Investigating the Overall Experience of Wearable Robots during Prototype-Stage Testing

Wearable robots (WRs) might interact with humans in a similar manner to teammates to accomplish specific tasks together. However, the available data on WR user experience (UX) studies are limited, especially during the prototyping phase. Therefore, this study aims to examine the overall experience of WRs during the prototyping phase based on an exploratory research model. This theoretical model considered usability, hedonic quality, and attitude toward using WRs as key factors in explaining and predicting overall experience. To test the hypotheses inherent in the research model, quantitative empirical research was conducted and the data were analyzed by partial least squares structural equation modeling (PLS-SEM). The results from the PLS-SEM analysis revealed the significance level of correlations between the latent variables in the research model. The exploratory research model was able to explain up to 53.2% of the variance in the overall experience of using WRs, indicating medium predictive power. This research develops a new quantitative empirical research model that can be used to explain and predict the overall experience of interactive products such as WRs. Meanwhile, the model is needed during WR testing in the prototype phase.

Comparing the Usability of the Web-Based 24-h Dietary Recall R24W and ASA24-Canada-2018 among French-Speaking Adults from Québec

Automated, self-administered, Web-based 24-h dietary recall tools are increasingly available for nutrition research in different settings, particularly in epidemiological studies and national surveys because of their practicality and efficiency. However, the usability of different 24-h dietary recall tools must be assessed and compared for use in specific populations as it is a major driver of the response rate and retention of participants. The primary aim of this study was to compare the usability of two validated, self-administered, web-based 24-h dietary recall tools available for the Canadian population: the R24W and the 2018 Canadian version of the ASA24. The R24W was developed in French for primary use in the province of Québec, Canada while the ASA24 was developed in English for primary use in the USA and recently adapted and translated for use in French-speaking Canadian adults. Whether the R24W and the ASA24-Canada-2018 yield similar nutritional data was also tested. In this randomized crossover study, 48 women and 20 men (mean age of 35 ± 14 years; range: 19−79 years) recruited in the province of Quebec completed the R24W and the ASA24-Canada-2018 in French twice on each occasion. Participants also completed the System Usability Scale (SUS), a reliable and valid scale giving a global view of subjective assessments of usability. Mean SUS score as well as mean dietary intakes of energy, nutrients and food groups generated by each tool were compared using mixed model analyses for repeated measures. On a scale of 0 to 100, the mean SUS scores (±SD) for the R24W and the ASA24-Canada-2018 were 81 ± 2 and 58 ± 2, respectively (p < 0.0001). 84% of participants stated that they would prefer to use the R24W if they were invited to complete additional 24-h dietary recalls. No significant difference was found between the R24W and the ASA24-Canada-2018 for the intake of energy, proteins, lipids, saturated fatty acids, carbohydrates, fibers, sodium and vegetables and fruits. In sum, while the R24W and the ASA24-Canada-2018 generate comparable self-reported dietary intake data, the R24W showed a better usability than the ASA24-Canada-2018 in a sample of French-speaking adults from the province of Quebec.

QFD-Based Research on Sustainable User Experience Optimization Design of Smart Home Products for the Elderly: A Case Study of Smart Refrigerators

In the current situation of global aging, the current market shortage of age-appropriate smart home products and the recent epidemic have led to greater isolation of the elderly, seriously affecting their physical and mental health. In order to optimize the sustainable user experience of the elderly when using smart home products, this paper proposes a research method based on Quality Function Deployment (QFD) for the optimal design of user experience of smart home products for the elderly, taking the design of age-appropriate home smart refrigerators as an example. Firstly, based on the results of market research and user interviews, the requirements of smart refrigerators for the elderly are screened and integrated, and the Kano model is used to prioritize these needs, resulting in the identification of important features needed in smart refrigerators for the elderly. Secondly, based on QFD, user requirements are transformed into design requirements, and a quality house model is established to ascertain the degree of importance of each design requirement through user ratings so as to obtain the key requirements as the theoretical basis for the solution design. Finally, optional solutions are generated for concept evaluation based on PUGH concept selection, comparing the advantages and disadvantages of the solutions and recombining them into an evaluation to determine the best solution. The quantitative evaluation of the four solutions reveals that Solution A has the highest score of 117.358, followed by Solution D with 113.259, Solution B with 96.415, and Solution C with 85.511, which is the lowest. The scoring allows the best design solution to be selected and applied to product development. The results show that the introduction of the Kano model and PUGH concept selection into QFD can be effectively used as a research method for optimizing the user experience of smart refrigerators for the elderly, and a corresponding design strategy for sustainable user experience optimization is proposed. The method and strategy provide guidance for the innovative design of new smart home products.

Smart Homes Supporting the Wellness of One or Two-Person Households

The reduction in face-to-face contact and the increase in time spent at home during the ongoing coronavirus disease pandemic have resulted in increasing interest and demand for smart homes. Further, the rapid increase in the number of one-person and two-person households in Korea recently has led to these becoming representative household types. This study identifies the wellness characteristics of such households and proposes a direction for smart home development to help them lead healthy, happy lives. It focuses on mapping residents' perceptions and experiences to scenarios and on identifying the functions required in smart homes and the technologies needed to provide these functions. It uses data from a survey to investigate and analyze the wellness characteristics of one- and two-person households in five dimensions and develops five scenarios of representative household types. By analyzing the developed scenarios, this study proposes smart homes that support the wellness of such households in six categories: exercise/sports, hobby/entertainment, social communications, occupation/work, self-development/education, and energy conservation. These households are exposed to digital environments from an early age and are familiar with the internet and technologies. Therefore, they are likely to adopt innovative technologies in housing. Thus, the smart home development proposed in this study is a promising strategic approach to housing planning.

Evaluation of a tactile breath pacer for sleep problems: A mixed method pilot study

Sleep problems, like insomnia, are a prevalent condition associated with major health risks. Prevention and treatment of sleep problems are thus essential to preserve physical and mental health. Previous work supports the effectiveness of breathing guidance for sleep problems and recommends breathing exercises as an effective intervention for insomnia. While new technologies can support breathing guidance, such novel devices should be assessed for effectiveness and usability to facilitate implementation and continued use. The current pilot study investigates the acceptability and usability of a mobile tactile breathing device and explores its potential impact on subjective sleep quality. In this mixed-method pilot study, 39 participants tested the breathing device for one month in naturalistic circumstances. We collected their experiences, subjective sleep quality, and feedback regarding the usability of the device and the accompanying app through a survey in a pre-post design. The results show that the breathing device is an acceptable solution for sleep problems and participants particularly appreciate the standalone function and design. Nevertheless, important points of attention, such as the size of the device, were also identified. Explorative analyses suggest that subjective sleep quality improved after using the device and accompanying app. The current study supports the usability and acceptability of a tactile breath pacer and provides preliminary evidence supporting a positive impact of the technology on the sleep quality of participants. Recommendations for developers of breathing technologies and eHealth are devised based on the findings.

Didactic Physician Assistant Students' Perceptions of Evidence-Based Medicine Resources: A Preliminary Investigation

Evidence-Based Medicine (EBM) instruction is required for physician Assistant (PA) students. This pilot study surveyed didactic PA students at three geographically diverse PA programs at the end of their didactic EBM course to understand which attributes of EBM resources they find most and least useful, and their self-efficacy in searching and appraising medical literature. Thematic analysis identified the most important student-reported attributes of a resource. PA students in this sample preferred UpToDate and PubMed as their top EBM tools based on attribute ratings. However, each database included in this pilot study received positive feedback, despite a low usage rate across institutions. The most important attributes were ease of use/search, information presentation, and conclusion/critical appraisal skill. After one EBM course, on average, students rated their self-efficacy searching the literature and appraising the literature as "moderately confident." This suggests that instructors and librarians have an opportunity to expose students to more tools as well as encourage "the right tool for the right job."

Development of a Website for a Living Network Meta-analysis of Atopic Dermatitis Treatments Using a User-Centered Design: Multimethod Study

BACKGROUND

A rapid expansion of systemic immunological treatment options for atopic dermatitis (AD) has created a need for clinically relevant and understandable comparative efficacy and safety information for patients and clinicians. Given the scarcity of head-to-head trials, network meta-analysis (NMA) is an alternative way to enable robust comparisons among treatment options; however, NMA results are often complex and difficult to directly implement in shared decision-making.

OBJECTIVE

The aim of this study is to develop a website that effectively presents the results of a living systematic review and NMA on AD treatments to patient and clinician users.

METHODS

We conducted a multimethod study using iterative feedback from adults with AD, adult caregivers of children with AD, dermatologists, and allergists within a user-centered design framework. We used questionnaires followed by workshops among patients and clinicians to develop and improve the website interface. Usability testing was done with a caregiver of a patient with eczema.

RESULTS

Questionnaires were completed by 31 adults with AD or caregivers and 94 clinicians. Patients and caregivers felt it was very important to know about new treatments (20/31, 65%). Clinicians felt the lack of evidence-based comparisons between treatments was a barrier to care (55/93, 59%). "Avoiding dangerous side effects" was ranked as the most important priority for patients (weighted ranking 5.2/7, with higher ranking being more important), and "improving patients' overall symptoms" was the most important priority for clinicians (weighted ranking 5.0/6). A total of 4 patients and 7 clinicians participated in workshops; they appreciated visualizations of the NMA results and found the website valuable for comparing different treatments. The patients suggested changes to simplify the interface and clarify terminology related to comparative efficacy. The user in the usability testing found the website intuitive to navigate.

CONCLUSIONS

We developed a website, "eczematherapies.com," with a user-centered design approach. Visualizations of NMA results enable users to compare treatments as part of their shared decision-making process.

User experience of self-reported computerized medical history taking for acute chest pain: The Clinical Expert Operating System Chest Pain Danderyd Study

BACKGROUND AND OBJECTIVE

Chest pain is one of the most common complaints in emergency departments (EDs). Self-reported computerized history taking (CHT) programmes can be used for interpretation of the clinical significance of medical information coming directly from patients. The adoption of CHT in clinical practice depends on reactions and attitudes to the technology from patients and their belief that the technology will have benefits for their medical care. The study objective was to explore the user experience of the self-reported CHT programme Clinical Expert Operating System (CLEOS) in the setting of patients visiting an ED for acute chest pain.

METHODS

This qualitative interview study is part of the ongoing CLEOS-Chest Pain Danderyd Study. A subset (n = 84) of the larger sample who had taken part in self-reported history taking during waiting times at the ED were contacted by telephone and n = 54 (64%) accepted participation. An interview guide with open-ended questions was used and the text was analysed using directed content analysis.

RESULTS

The patients' experiences of the CLEOS programme were overall positive although some perceived it as extensive. The programme was well accepted and despite the busy environment, patients were highly motivated and deemed it helpful to make a diagnosis. Six categories of user experience emerged: The clinical context, The individual context, Time aspect, Acceptability of the programme, Usability of the programme and Perceptions of usefulness in a clinical setting.

CONCLUSIONS

The programme was well accepted by most patients in the stressful environment at ED although some found it difficult to answer all the questions. Adjustments to the extent of an interview to better suit the context of the clinical use should be a future development of the programme. The findings suggest that CHT programmes can be integrated as a standard process for collecting self-reported medical history data in the ED setting.

The Challenges Toward Real-world Implementation of Digital Health Design Approaches: Narrative Review

BACKGROUND

Digital health represents an important strategy in the future of health care delivery. Over the past decade, mobile health has accelerated the agency of health care users. Despite prevailing excitement about the potential of digital health, questions remain on efficacy, uptake, usability, and patient outcome. This challenge is confounded by 2 industries, digital and health, which have vastly different approaches to research, design, testing, and implementation. In this regard, there is a need to examine prevailing design approaches, weigh their benefits and challenges toward implementation, and recommend a path forward that synthesizes the needs of this complex stakeholder group.

OBJECTIVE

In this review, we aimed to study prominent digital health intervention design approaches that mediate the digital health space. In doing so, we sought to examine the origins, perceived benefits, contrasting nuances, challenges, and typical use-case scenarios of each methodology.

METHODS

A narrative review of digital health design approaches was performed between September 2020 and April 2021 by referencing keywords such as "digital health design," "mHealth design," "e-Health design," "agile health," and "agile healthcare." The studies selected after screening were those that discussed the design and implementation of digital health design approaches. A total of 120 studies were selected for full-text review, of which 62 (51.6%) were selected for inclusion in this review.

RESULTS

A review identifying the 5 overarching digital health design approaches was compiled: user-centered design, person-based design, human-centered design, patient-centered design, and patient-led design. The findings were synthesized in a narrative structure discussing the origins, advantages, disadvantages, challenges, and potential use-case scenarios.

CONCLUSIONS

Digital health is experiencing the growing pains of rapid expansion. Currently, numerous design approaches are being implemented to harmonize the needs of a complex stakeholder group. Whether the end user is positioned as a person, patient, or user, the challenge to synthesize the constraints and affordances of both digital design and health care, built equally around user satisfaction and clinical efficacy, remains paramount. Further research that works toward a transdisciplinarity in digital health may help break down friction in this field. Until digital health is viewed as a hybridized industry with unique requirements rather than one with competing interests, the nuances that each design approach posits will be difficult to realize in a real-world context. We encourage the collaboration of digital and health experts within hybrid design teams, through all stages of intervention design, to create a better digital health culture and design ethos.

Informal carers' support needs, facilitators and barriers in the transitional care of older adults: A qualitative study

INTRODUCTION

Inclusion of informal carers in transitional care is challenging because of fast throughput and service fragmentation. This study aimed to understand informal carers' needs during the care transitions of older adults from inpatient care to the community.

METHODS

A qualitative exploratory design was used with mixed-methods data collection. Seventeen semi-structured telephone interviews were conducted with family carers; one focus group was conducted by videoconference with two family carers and three community-based advocacy and aged care providers; and eight semi-structured telephone interviews were undertaken with healthcare practitioners from rehabilitation services. Data were thematically analysed.

FINDINGS

All carers described the main social challenge that they needed to address in transitional care as 'Needing to sustain family'. Carers reported their social needs across five solutions: 'Partnering with carers', 'Advocating for discharge', 'Accessing streamlined multidisciplinary care', 'Knowing how to care' and 'Accessing follow-up care in the community'. Focus group participants endorsed the findings from the carer interviews and added the theme 'Putting responsibility back onto carers'. All healthcare practitioners described the main social challenge that they needed to address as 'Needing to engage carers'. They reported their social solutions in three themes: 'Communicating with carers', 'Planning with carers' and 'Educating carers'.

DISCUSSION

Findings highlight the importance of reconstructing the meaning of transitional care and relevant outcomes to be inclusive of carers' experiences and their focus on sustaining family. Transitional care that includes carers should commence at the time of hospital admission of the older adult.

CONCLUSIONS

Future sustainable and high-quality health services for older adults will require transitional care that includes carers and older adults and efficient use of inpatient and community care resources. Healthcare professionals will require education and skills in the provision of transitional care that includes carers. To meet carers' support needs, models of transitional care inclusive of carers and older adults should be developed, implemented and evaluated.

PUBLIC CONTRIBUTION

This study was conducted with the guidance of a Carer Advisory Group comprising informal carers with experience of care transitions of older adults they support and community-based organizations providing care and advocacy support to informal carers.

University Library Space Renovation Based on the User Learning Experience in Two Wuhan Universities

University library spaces play an important role in the learning experience of students. However, the traditional designs for these learning spaces no longer meet the needs of users, and researchers have been turning their attention to university library space renovation. By combing existing theories and practices, this study determined a framework of six university library space renovation design principles and subsequently conducted a survey to examine university library space user learning experience in two university libraries in Wuhan, China. Data analysis was conducted using SPSS. From the questionnaire-based survey results, this study determined seven design elements that affect the learning experience of university library users. The results of binary logistic regression showed that two elements, indoor physical space comfort and indoor acoustic environment comfort, have positive effects on the frequency and length of visits to the library. Key spatial elements that can promote library space users' learning experience were also identified, thus providing data that can reliably inform future design strategies for the space renovation of university libraries.

Usability of Electronic Health Records in Germany - An Overview of Satisfaction of University Hospital Physicians

INTRODUCTION

EHR are a part of daily task of physicians in Germany. This study surveyed the satisfaction of a small group of physicians in German university hospitals using EHR with focus on usability.

METHODS

The questioning was carried out by an online survey. Addressed were all physicians working at university hospitals in Germany.

RESULTS

The study showed that users are not satisfied with EHR (Grade 3.62). They pointed out some problems in general but reflected many advantages of those systems.

CONCLUSION

EHR systems have to develop and adopt to users' tasks. They have to get faster and low error rates must be realized. Existing infrastructure must be improved and rolled out to users especially in times where digital healthcare services gain importance.

Effect on Perceived Weight of Object Shapes

The perceived weight of an object is an important research topic in terms of sensation and perception, and it is known that it has size-weight, color-weight, and material-weight illusions due to the influence of size, color, and material, as well as the weight of the object. Although the physical size of an object is measured by volume, the size of an object that we subjectively feel depends on the shape of the object, even if it has the same volume. Therefore, the shape of the object may determine the perceived size of the object, thereby changing its perceived weight accordingly. These cognitive factors play an important role in the period of rehabilitation therapy after an exacerbation or attack of neurological diseases, such as stroke or Parkinson's disease, regarding the motor functions of the patient. Moreover, the study of these sensation and perception factors is important for the period of the early development of children, for example, for tracking and correcting fine motor skills. Existing related studies analyzed the perceived weight according to three shapes (tetrahedron, cube, and sphere), but only some shapes showed a difference in the perceived weight. This study attempted to demonstrate the difference in perceived weight according to the shape that has yet to be clearly identified. To this end, this study investigated objects with the same physical size (volume) as in previous studies, but in the shapes of tetrahedron, cube, and sphere. In addition, the volumes of these objects were set to 64,000 cm³, 125,000 cm³, and 216,000 cm³, and their weights were set to be 100 g, 150 g, and 200 g, in proportion to the size of the small, medium, and large volumes, respectively. Thirty-eight college students (21 males, 17 females) participated and the perceived weight of a given object compared to a reference object was evaluated according to the modulus method used for sensory size measurement. The analysis of the experimental data found that both weight (volume) and shape had significant effects on the perceived weight. The results support that the shape of objects also led to the size-weight illusion phenomenon. At the same weight (volume), the perceived weight of an object according to shape decreased significantly in the order of sphere, cube, and tetrahedron. At the same volume level, subjective size according to shape is small in the order of tetrahedron, cube, and sphere. The results of weight perception according to shape in this study showed that the subjective size of an object according to shape had an effect on perceived weight.

Intelligent User Interfaces and Their Evaluation: A Systematic Mapping Study

Intelligent user interfaces (IUI) are driven by the goal of improvement in human-computer interaction (HCI), mainly improving user interfaces' user experience (UX) or usability with the help of artificial intelligence. The main goal of this study is to find, assess, and synthesize existing state-of-the-art work in the field of IUI with an additional focus on the evaluation of IUI. This study analyzed 211 studies published in the field between 2012 and 2022. Studies are most frequently tied to HCI and SE domains. Definitions of IUI were observed, showing that adaptation, representation, and intelligence are key characteristics associated with IUIs, whereas adaptation, reasoning, and representation are the most commonly used verbs in their description. Evaluation of IUI is mainly conducted with experiments and questionnaires, though usability and UX are not considered together in evaluations. Most evaluations (81% of studies) reported partial or complete improvement in usability or UX. A shortage of evaluation tools, methods, and metrics, tailored for IUI, is noticed. Most often, empirical data collection methods and data sources in IUI evaluation studies are experiment, prototype development, and questionnaire.

Digital Patient Experience: Umbrella Systematic Review

BACKGROUND

The adoption and use of technology have significantly changed health care delivery. Patient experience has become a significant factor in the entire spectrum of patient-centered health care delivery. Digital health facilitates further improvement and empowerment of patient experiences. Therefore, the design of digital health is served by insights into the barriers to and facilitators of digital patient experience (PEx).

OBJECTIVE

This study aimed to systematically review the influencing factors and design considerations of PEx in digital health from the literature and generate design guidelines for further improvement of PEx in digital health.

METHODS

We performed an umbrella systematic review following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology. We searched Scopus, PubMed, and Web of Science databases. Two rounds of small random sampling (20%) were independently reviewed by 2 reviewers who evaluated the eligibility of the articles against the selection criteria. Two-round interrater reliability was assessed using the Fleiss-Cohen coefficient (k1=0.88 and k2=0.80). Thematic analysis was applied to analyze the extracted data based on a small set of a priori categories.

RESULTS

The search yielded 173 records, of which 45 (26%) were selected for data analysis. Findings and conclusions showed a great diversity; most studies presented a set of themes (19/45, 42%) or descriptive information only (16/45, 36%). The digital PEx-related influencing factors were classified into 9 categories: patient capability, patient opportunity, patient motivation, intervention technology, intervention functionality, intervention interaction design, organizational environment, physical environment, and social environment. These can have three types of impacts: positive, negative, or double edged. We captured 4 design constructs (personalization, information, navigation, and visualization) and 3 design methods (human-centered or user-centered design, co-design or participatory design, and inclusive design) as design considerations.

CONCLUSIONS

We propose the following definition for digital PEx: "Digital patient experience is the sum of all interactions affected by a patient's behavioral determinants, framed by digital technologies, and shaped by organizational culture, that influence patient perceptions across the continuum of care channeling digital health." In this study, we constructed a design and evaluation framework that contains 4 phases-define design, define evaluation, design ideation, and design evaluation-and 9 design guidelines to help digital health designers and developers address digital PEx throughout the entire design process. Finally, our review suggests 6 directions for future digital PEx-related research.

A Biofeedback-Based Mobile App With Serious Games for Young Adults With Anxiety in the United Arab Emirates: Development and Usability Study

Background

Following the outbreak of COVID-19, several studies have reported that young adults encountered a rise in anxiety symptoms, which could negatively affect their quality of life. Promising evidence suggests that mobile apps with biofeedback, serious games, breathing exercises, and positive messaging, among other features, are useful for anxiety self-management and treatment.

Objective

This study aimed to develop and evaluate the usability of a biofeedback-based app with serious games for young adults with anxiety in the United Arab Emirates (UAE).

Methods

This study consists of two phases: Phase I describes the design and development of the app, while Phase II presents the results of a usability evaluation by experts. To elicit the app’s requirements during Phase I, we conducted (1) a survey to investigate preferences of young adults in the UAE for mobile games for stress relief; (2) an analysis of serious games for anxiety; and (3) interviews with mental health professionals and young adults in the UAE. In Phase II, five experts tested the usability of the developed app using a set of Nielsen’s usability heuristics.

Results

A fully functional biofeedback-based app with serious games was co-designed with mental health professionals. The app included 4 games (ie, a biofeedback game, card game, arcade game, and memory game), 2 relaxation techniques (ie, a breathing exercise and yoga videos), and 2 additional features (ie, positive messaging and a mood tracking calendar). The results of Phase II showed that the developed app is efficient, simple, and easy to use. Overall, the app design scored an average of 4 out of 5.

Conclusions

The elicitation techniques used in Phase I resulted in the development of an easy-to-use app for the self-management of anxiety. Further research is required to determine the app’s usability and effectiveness in the target population.

How to design font size for older adults: A systematic literature review with a mobile device

With the global society aging, it is necessary to investigate suitable font size based on reading time/speed, readability and legibility for older adults. This study used a systematic review of previous and existing relevant research on font size for older adults and research on the psychophysics of reading and analyzed the outcomes based on reading time/speed, readability, legibility and the usability evaluation methods employed. Studies were selected from databases GOOGLE SCHOLAR, WEB OF SCIENCE, PUBMED, and SCIENCE DIRECT. An inclusion criterion was used to remove duplicates and avoid inconsistencies. Results suggest that older adults preferred larger font sizes. However, there exists a critical size at which readability declines. Inconsistencies in evaluation methods and experimental procedures were observed in the selected articles. This study suggested a reusable catalog of usability evaluation methods, eye tracking for user testing and a questionnaire for inquiry as suitable usability evaluation methods, a uniform metrics to measure font size (visual angle of font) in arcminutes and parameters to consider when investigating font size for older adults to ensure consistency in future studies.

Revitalization of the Waterfront Park Based on Industrial Heritage Using Post-Occupancy Evaluation-A Case Study of Shanghai (China)

With the rapid development of urban construction, the waterfront industrial heritage park has played an active role in shaping the city’s image, regional economic development and environmental improvement, and the continuation of the city’s waterfront history. The waterfront park based on industrial heritage using post-occupancy evaluation will help improve the sustainable management, maintenance, and design level of the project in the future. However, there is insufficient research on the waterfront industrial heritage park using post-occupancy evaluation. This paper takes Shanghai Houtan Park and Xuhui Binjiang Park, the representative industrial heritage parks in China, as the research objects. Through field investigation and nearly 200 questionnaires and interviews regarding user behavior, the importance of design elements (place characteristics, natural environmental characteristics, usability characteristics, and administrative characteristics) and the correlation of satisfaction help us to understand the use of the two parks and analyze and organize the survey data, carrying out the analysis of the questionnaire results using frequency analysis, IPA analysis, t-test, variance analysis, and multiple regression analysis. The research results include: (1) Both parks are mainly used by people in their twenties and forties, and the trail received the highest utilization rate as the main facility, while the visitor center in charge of guiding functions had the lowest utilization rate. (2) While Houtan Park received high satisfaction with natural environmental characteristics, it was found that Xu Hui Binjiang Park had relatively high satisfaction with the place and usability characteristics. (3) The natural environmental characteristics of Houtan Park have a positive impact on overall satisfaction and return visit satisfaction. Site characteristics and utilization characteristics of Xuhui Binjiang Industrial Park have a positive impact on overall satisfaction, while usability characteristics have a positive impact on return visit satisfaction. Finally, according to the questions and suggestions raised by users, an optimization strategy is proposed for the renewal of the park, and it is hoped that it can provide suggestions for the reconstruction and design of similar Chinese waterfront industrial heritage parks.

An Autoscaling Platform Supporting Graph Data Modelling Big Data Analytics

Big Data has proved to be vast and complex, without being efficiently manageable through traditional architectures, whereas data analysis is considered crucial for both technical and non-technical stakeholders. Current analytics platforms are siloed for specific domains, whereas the requirements to enhance their use and lower their technicalities are continuously increasing. This paper describes a domain-agnostic single access autoscaling Big Data analytics platform, namely Diastema, as a collection of efficient and scalable components, offering user-friendly analytics through graph data modelling, supporting technical and non-technical stakeholders. Diastema's applicability is evaluated in healthcare through a predicting classifier for a COVID19 dataset, considering real-world constraints.

Understanding the Mechanism of User Experience Role in Educational Livestreaming Platform

The booming development of educational livestreaming platforms has caused the prevalence of user experience to a certain extent, which profoundly affects users' purchase intention and behavior, and has become a hot topic of current research in the online education field. However, there is a lack of in-depth analysis on the mechanism of the role of user experience in influencing purchase intention. Based on the analysis of user experience and psychological ownership, this study constructs a moderated mediation model to investigate the mediating psychological mechanism and boundary conditions of user experience affecting purchase intention. In this study, a valid sample of 372 users was used for structural equation modeling analysis. The results of the study found that user experience not only had a significant positive effect on purchase intention but was also mediated by psychological ownership. We also found that the effect of psychological ownership on purchase intention was moderated by privacy concerns. This study examines the role of user experience in purchase intention and reveals the mechanism of the role of user experience in an educational livestreaming platform.

Healthcare Professionals' Experience of Performing Digital Care Visits-A Scoping Review

The use of digital care visits has been increasing during the COVID-19 pandemic. Learning more about healthcare professionals' technology experiences provides valuable insight and a basis for improving digital visits. This study aimed to explore the existing literature on healthcare professionals' experience performing digital care visits. A scoping review was performed following Arksey & O'Malley's proposed framework using the Preferred Reporting Items for Systematic reviews and Meta-Analyses. The collected data were analyzed using thematic content analysis. Five main themes were identified in the literature: positive experiences/benefits, facilitators, negative experiences/challenges, barriers, and suggestions for improvement. Healthcare professionals mostly reported having an overall positive experience with digital visits and discovered benefits for themselves and the patients. However, opinions were mixed or negative regarding the complexity of decision making, workload and workflow, suitability of this type of care, and other challenges. The suggestions for improvement included training and education, improvements within the system and tools, along with support for professionals. Despite overall positive experiences and benefits for both professionals and patients, clinicians reported challenges such as physical barriers, technical issues, suitability concerns, and others. Digital care visits could not fully replace face-to-face visits.

Human-Centered Design Approaches in Digital Mental Health Interventions: Exploratory Mapping Review

BACKGROUND

Digital mental health interventions have a great potential to alleviate mental illness and increase access to care. However, these technologies face significant challenges, especially in terms of user engagement and adoption. It has been suggested that this issue stems from a lack of user perspective in the development process; accordingly, several human-centered design approaches have been developed over the years to consider this important aspect. Yet, few human-centered design approaches to digital solutions exist in the field of mental health, and rarely are end users involved in their development.

OBJECTIVE

The main objective of this literature review is to understand how human-centered design is considered in e-mental health intervention research.

METHODS

An exploratory mapping review was conducted of mental health journals with the explicit scope of covering e-mental health technology. The human-centered design approaches reported and the core elements of design activity (ie, object, context, design process, and actors involved) were examined among the eligible studies.

RESULTS

A total of 30 studies met the inclusion criteria, of which 22 mentioned using human-centered design approaches or specific design methods in the development of an e-mental health solution. Reported approaches were classified as participatory design (11/27, 41%), codesign (6/27, 22%), user-centered design (5/27, 19%), or a specific design method (5/27, 19%). Just over half (15/27, 56%) of the approaches mentioned were supported by references. End users were involved in each study to some extent but not necessarily in designing. About 27% (8/30) of all the included studies explicitly mentioned the presence of designers on their team.

CONCLUSIONS

Our results show that some attempts have indeed been made to integrate human-centered design approaches into digital mental health technology development. However, these attempts rely very little on designers and design research. Researchers from other domains and technology developers would be wise to learn the underpinnings of human-centered design methods before selecting one over another. Inviting designers for assistance when implementing a particular approach would also be beneficial. To further motivate interest in and use of human-centered design principles in the world of e-mental health, we make nine suggestions for better reporting of human-centered design approaches in future research.

Placing Users at the Center: Evaluating Exam Room Design for Improved User Experience

OBJECTIVE

This article proposes a method for evaluating the design affordances of primary care exam rooms from the perspectives of users using functional scenario (FS) analysis.

GOAL

This study aims to develop quantifiable criteria and spatial metrics for evaluating how exam room design supports the needs of different users. These criteria and metrics can be used in the early stages of the design process to choose between alternatives.

BACKGROUND

The primary care exam room is an essential space in healthcare, as it is the first point of contact between the healthcare provider and the patient. However, there is a lack of rigorous evaluation metrics for exam room design that supports improved user experiences and better health outcomes.

METHOD

A total of nine primary care exam rooms were analyzed using FS analysis. We identified three key user groups involved in the clinical examination process-providers, patients, and care partners-and translated their needs into FSs. We developed spatial metrics for each FS to quantify the extent to which the needs were spatially supported.

RESULTS

We developed 11 FSs in total: three from the providers', five from the patients', and three from the care partners' perspectives. The results revealed possible design strategies for improved user experiences.

CONCLUSIONS

We quantitatively measured the affordance of primary care exam room design for multiple stakeholders. We expect that the criteria and metrics presented in this article will improve the understanding of different users' perspectives and provide new design guidance for improved user experiences.

Usability-Focused Development and Usage of NeoTree-Beta, an App for Newborn Care in a Low-Resource Neonatal Unit, Malawi

Background

Neonatal mortality is high in low-resource settings. NeoTree is a digital intervention for neonatal healthcare professionals (HCPs) aiming to achieve data-driven quality improvement and improved neonatal survival in low-resource hospitals. Optimising usability with end-users could help digital health interventions succeed beyond pilot stages in low-resource settings. Usability is the quality of a user's experience when interacting with an intervention, encompassing their effectiveness, efficiency, and overall satisfaction.

Objective

To evaluate the usability and usage of NeoTree beta-app and conduct Agile usability-focused intervention development.

Method

A real-world pilot of NeoTree beta-app was conducted over 6 months at Kamuzu Central Hospital neonatal unit, Malawi. Prior to deployment, think-aloud interviews were conducted to guide nurses through the app whilst voicing their thoughts aloud (n = 6). System Usability Scale (SUS) scores were collected before the implementation of NeoTree into usual clinical care and 6 months after implementation (n = 8 and 8). During the pilot, real-world user-feedback and user-data were gathered. Feedback notes were subjected to thematic analysis within an Agile “product backlog.” For usage, number of users, user-cadre, proportion of admissions/outcomes recorded digitally, and median app-completion times were calculated.

Results

Twelve overarching usability themes generated 57 app adjustments, 39 (68%) from think aloud analysis and 18 (32%) from the real-world testing. A total of 21 usability themes/issues with corresponding app features were produced and added to the app. Six themes relating to data collection included exhaustiveness of data schema, prevention of errors, ease of progression, efficiency of data entry using shortcuts, navigation of user interface (UI), and relevancy of content. Six themes relating to the clinical care included cohesion with ward process, embedded education, locally coherent language, adaptability of user-interface to available resources, and printout design to facilitate handover. SUS scores were above average (88.1 and 89.4 at 1 and 6 months, respectively). Ninety-three different HCPs of 5 cadres, recorded 1,323 admissions and 1,197 outcomes over 6 months. NeoTree achieved 100% digital coverage of sick neonates admitted. Median completion times were 16 and 8 min for admissions and outcomes, respectively.

Conclusions

This study demonstrates optimisation of a digital health app in a low-resource setting and could inform other similar usability studies apps in similar settings.

Social Media and Online Digital Technology Use Among Muslim Young People and Parents: Qualitative Focus Group Study

BACKGROUND

Digital technology and social media use are common among young people in Australia and worldwide. Research suggests that young people have both positive and negative experiences online, but we know little about the experiences of Muslim communities.

OBJECTIVE

This study aims to explore the positive and negative experiences of digital technology and social media use among young people and parents from Muslim backgrounds in Melbourne, Victoria, Australia.

METHODS

This study involved a partnership between researchers and a not-for-profit organization that work with culturally and linguistically diverse communities. We adopted a participatory and qualitative approach and designed the research in consultation with young people from Muslim backgrounds. Data were collected through in-person and online focus groups with 33 young people aged 16-22 years and 15 parents aged 40-57 years. Data were thematically analyzed.

RESULTS

We generated 3 themes: (1) maintaining local and global connections, (2) a paradoxical space: identity, belonging and discrimination, and (3) the digital divide between young Muslims and parents. Results highlighted that social media was an important extension of social and cultural connections, particularly during COVID-19, when people were unable to connect through school or places of worship. Young participants perceived social media as a space where they could establish their identity and feel a sense of belonging. However, participants were also at risk of being exposed to discrimination and unrealistic standards of beauty and success. Although parents and young people shared some similar concerns, there was a large digital divide in online experiences. Both groups implemented strategies to reduce social media use, with young people believing that having short technology-free breaks during prayer and quality family time was beneficial for their mental well-being.

CONCLUSIONS

Programs that address technology-related harms must acknowledge the benefits of social media for young Muslims across identity, belonging, representation, and social connection. Further research is required to understand how parents and young people can create environments that foster technology-free breaks to support mental well-being.

Persuasive Design Techniques and App Design Recommendations to Improve Health Workforce Capability in Rural Health Professionals: What Do Users Want and How Does an App Help?

BACKGROUND

Health professionals' perceptions of persuasive design techniques for use in technological solutions to improve health workforce capability have not been previously explored.

OBJECTIVE

This study aims to explore rural health professionals' perceptions of health workforce capability and persuasive design techniques; and translate these into recommendations for designing a health workforce capability app to increase their impact and usefulness.

METHODS

Qualitative interviews with 13 rural health professionals were conducted. Subsequently, 32 persuasive techniques were used as a framework to deductively analyze the data. Persuasive design technique domains were Primary Task Support, Dialog Support, System Credibility Support, Social Support, and Cialdini's Principles of Persuasion.

RESULTS

Persuasive design techniques can be applied across the factors that influence health workforce capability including health and personal qualities; competencies and skills; values, attitudes, and motivation; and factors that operate outside of work and at the team, organizational, and labor market levels. The majority of the 32 persuasive design techniques were reflected in the data from the interviews and led to recommendations as to how these could be translated into practice, with the exception of scarcity. Many suggestions and persuasive design techniques link back to the need for tailored and localized solutions such as the need for country-specific-based evidence, the wish for localized communities of practice, learning from other rural health professionals, and referral pathways to other clinicians. Participants identified how persuasive design techniques can optimize the user experience to help meet rural health professionals needs for more efficient systems to improve patient access to care, quality care, and to enable working in interprofessional team-based care. Social inclusion plays a vital role for health professionals, indicating the importance of the Social Support domain of persuasive techniques. Overall, health professionals were open to self-monitoring of their work performance and some professionals used wearables to monitor their health.

CONCLUSIONS

Rural health professionals' perceptions of health workforce capability informed which persuasive design techniques can be used to optimize the user experience of an app. These were translated into recommendations for designing a health workforce capability app to increase likelihood of adoption. This study has also contributed to the further validation of the Persuasive Systems Design model through empirically aligning elements of the model to increase persuasive system content and functionality with real-world applied data, in this case the health workforce capability of rural health professionals. Our findings confirm that these techniques can be used to develop a future prototype of an app that may assist health professionals in improving or maintaining their health workforce capability which in turn may increase recruitment and retention in rural areas. Health professionals need to be central during the design phase. Interventions are needed to provide a supportive environment to rural and remote health professionals to increase their rural health workforce capability.

Dual Passive Reactive Brain-Computer Interface: A Novel Approach to Human-Machine Symbiosis

The present study proposes a novel concept of neuroadaptive technology, namely a dual passive-reactive Brain-Computer Interface (BCI), that enables bi-directional interaction between humans and machines. We have implemented such a system in a realistic flight simulator using the NextMind classification algorithms and framework to decode pilots' intention (reactive BCI) and to infer their level of attention (passive BCI). Twelve pilots used the reactive BCI to perform checklists along with an anti-collision radar monitoring task that was supervised by the passive BCI. The latter simulated an automatic avoidance maneuver when it detected that pilots missed an incoming collision. The reactive BCI reached 100% classification accuracy with a mean reaction time of 1.6 s when exclusively performing the checklist task. Accuracy was up to 98.5% with a mean reaction time of 2.5 s when pilots also had to fly the aircraft and monitor the anti-collision radar. The passive BCI achieved a F1-score of 0.94. This first demonstration shows the potential of a dual BCI to improve human-machine teaming which could be applied to a variety of applications.

A Remote Patient-Monitoring System for Intensive Care Medicine: Mixed Methods Human-Centered Design and Usability Evaluation

Background

Continuous monitoring of vital signs is critical for ensuring patient safety in intensive care units (ICUs) and is becoming increasingly relevant in general wards. The effectiveness of health information technologies such as patient-monitoring systems is highly determined by usability, the lack of which can ultimately compromise patient safety. Usability problems can be identified and prevented by involving users (ie, clinicians).

Objective

In this study, we aim to apply a human-centered design approach to evaluate the usability of a remote patient-monitoring system user interface (UI) in the ICU context and conceptualize and evaluate design changes.

Methods

Following institutional review board approval (EA1/031/18), a formative evaluation of the monitoring UI was performed. Simulated use tests with think-aloud protocols were conducted with ICU staff (n=5), and the resulting qualitative data were analyzed using a deductive analytic approach. On the basis of the identified usability problems, we conceptualized informed design changes and applied them to develop an improved prototype of the monitoring UI. Comparing the UIs, we evaluated perceived usability using the System Usability Scale, performance efficiency with the normative path deviation, and effectiveness by measuring the task completion rate (n=5). Measures were tested for statistical significance using a 2-sample t test, Poisson regression with a generalized linear mixed-effects model, and the N-1 chi-square test. P<.05 were considered significant.

Results

We found 37 individual usability problems specific to monitoring UI, which could be assigned to six subcodes: usefulness of the system, response time, responsiveness, meaning of labels, function of UI elements, and navigation. Among user ideas and requirements for the UI were high usability, customizability, and the provision of audible alarm notifications. Changes in graphics and design were proposed to allow for better navigation, information retrieval, and spatial orientation. The UI was revised by creating a prototype with a more responsive design and changes regarding labeling and UI elements. Statistical analysis showed that perceived usability improved significantly (System Usability Scale design A: mean 68.5, SD 11.26, n=5; design B: mean 89, SD 4.87, n=5; P=.003), as did performance efficiency (normative path deviation design A: mean 8.8, SD 5.26, n=5; design B: mean 3.2, SD 3.03, n=5; P=.001), and effectiveness (design A: 18 trials, failed 7, 39% times, passed 11, 61% times; design B: 20 trials, failed 0 times, passed 20 times; P=.002).

Conclusions

Usability testing with think-aloud protocols led to a patient-monitoring UI with significantly improved usability, performance, and effectiveness. In the ICU work environment, difficult-to-use technology may result in detrimental outcomes for staff and patients. Technical devices should be designed to support efficient and effective work processes. Our results suggest that this can be achieved by applying basic human-centered design methods and principles.

Trial Registration

ClinicalTrials.gov NCT03514173; https://clinicaltrials.gov/ct2/show/NCT03514173

User Experience (UX) Librarianship and Health Sciences Libraries (HSLs)

This article provides the results of an investigation into how health sciences librarians with user experience (UX) duties describe their roles and initiatives. Through an online survey, 40 respondents provided details on institutional demographics, work plans, participant recruitment, and data collection. Four interviews were also conducted. This investigation provides perspectives on UX within the health sciences library (HSL) environment including barriers and successes. It is hoped that the results of this article will influence research into timely and efficient UX initiatives within HSLs and provide librarians, staff, and administrators the information they need to support decision making.