What drives the vaccination intention against COVID-19? Application of EPPM, TAM, and theories of risk assessment

Vaccines are widely used to fight against COVID-19. However, COVID-19 vaccine hesitancy appears as some individuals are concerned with COVID-19 vaccines. This study investigates the vaccination intention against COVID-19 in China with the Extended Parallel Process Model (EPPM), Technology Acceptance Model (TAM), and theories of risk information assessment. Results showed that the formation mechanism of vaccination intention could be considered a psychological process, as subjective knowledge was a primary influence on correspondents' weighting of both the potentially positive (usefulness) and negative effects (threat) of vaccination. This unequal consideration then resulted in different levels of fear arousal between subjects. Driven by usefulness/threat perception and fear, people conducted different decision strategies, so-called analytical assessment, and experiential assessment to make vaccination decision. In addition to the direct effects of experiential assessment on vaccination intention, two decision strategies and fear arousal also affected people's vaccination intention through the mediation role of vaccination attitude. For policymakers and stakeholders, this study provides a knowledge base for confidence-building, and emotional guidance concerning against COVID-19 vaccination.

Helping patient educators meet health literacy needs: End-user testing and iterative development of an innovative health literacy editing tool

Objective

The Sydney Health Literacy Lab (SHeLL) Editor is an online text-editing tool that provides real-time assessment and feedback on written health information (assesses grade reading score, complex language, passive voice). This study aimed to explore how the design could be further enhanced to help health information providers interpret and act on automated feedback.

Methods

The prototype was iteratively refined across four rounds of user-testing with health services staff (N = 20). Participants took part in online interviews and a brief follow-up survey using validated usability scales (System Usability Scale, Technology Acceptance Model). After each round, Yardley's (2021) optimisation criteria guided which changes would be implemented.

Results

Participants rated the Editor as having adequate usability (M = 82.8 out of 100, SD = 13.5). Most modifications sought to reduce information overload (e.g. simplifying instructions for new users) or make feedback motivating and actionable (e.g. using frequent incremental feedback to highlight changes to the text altered assessment scores).

Conclusion

terative user-testing was critical to balancing academic values and the practical needs of the Editor's target users. The final version emphasises actionable real-time feedback and not just assessment.

Innovation

The Editor is a new tool that will help health information providers apply health literacy principles to written text.

Chatbots for future docs: exploring medical students' attitudes and knowledge towards artificial intelligence and medical chatbots

Artificial intelligence (AI) in medicine and digital assistance systems such as chatbots will play an increasingly important role in future doctor - patient communication. To benefit from the potential of this technical innovation and ensure optimal patient care, future physicians should be equipped with the appropriate skills. Accordingly, a suitable place for the management and adaptation of digital assistance systems must be found in the medical education curriculum. To determine the existing levels of knowledge of medical students about AI chatbots in particular in the healthcare setting, this study surveyed medical students of the University of Luebeck and the University Hospital of Tuebingen. Using standardized quantitative questionnaires and qualitative analysis of group discussions, the attitudes of medical students toward AI and chatbots in medicine were investigated. From this, relevant requirements for the future integration of AI into the medical curriculum could be identified. The aim was to establish a basic understanding of the opportunities, limitations, and risks, as well as potential areas of application of the technology. The participants (N = 12) were able to develop an understanding of how AI and chatbots will affect their future daily work. Although basic attitudes toward the use of AI were positive, the students also expressed concerns. There were high levels of agreement regarding the use of AI in administrative settings (83.3%) and research with health-related data (91.7%). However, participants expressed concerns that data protection may be insufficiently guaranteed (33.3%) and that they might be increasingly monitored at work in the future (58.3%). The evaluations indicated that future physicians want to engage more intensively with AI in medicine. In view of future developments, AI and data competencies should be taught in a structured way during the medical curriculum and integrated into curricular teaching.

Communicating about online health information with patients: Exploring determinants among telemental health providers

Objective

To investigate determinants of telemental health (TMH) providers' openness to discuss and confidence to use online mental health information with patients, focusing on providers' eHealth literacy and perceived usefulness of online MH information.

Methods

TMH providers (N = 472) completed a web-based survey with questions about discussing and using online health information with patients, perceived usefulness of the Internet as a source of patient information, and eHealth literacy.

Results

Providers were open to discussing online health information with patients if they were not treating substance abuse disorders (b = -0.83), felt the Internet was a useful resource (b = 0.18), and felt confident in their skills to evaluate the online information (b = 0.21). Providers were confident using online health information if they worked in a small clinic (b = 0.37), felt the Internet was a useful resource (b = 0.31), knew where to access relevant online health information (b = 0.13), and had skills to help their patients find (b = 0.17) and evaluate (b = 0.54) online information.

Conclusion

TMH providers are likely to use online health information resources if they know where and how to find them and perceive the Internet as a useful resource.

Innovation

To effectively discuss online health information with patients, providers require skills to evaluate the information with patients.

Hope for the best, but prepare for the worst: Social media posted by participants in stem cell clinical trials

This article examines the influence of social media posts on clinical trials involving stem cell-based interventions. Based on the literature review, we identified three potential risks associated with social media posts regarding clinical trials that involve stem cell-based interventions: (1) threats to scientific validity, (2) amplification of excessive expectations, and (3) breaches of confidentiality. Additionally, preliminary recommendations are provided to safeguard the value of stem cell clinical trials for future patients in the age of social media. Our approach aims to safeguard the well-being of forthcoming participants and ensure the scientific validity of stem cell research, as well as possibly aid in the further development of shared guidelines for posting stem cell clinical trial information on social media platforms.

A smartphone-based online platform for clinical skills training and assessment with standardized patients: platform development and pilot study outcomes

There are limitations and difficulties in the management of traditional in-person standardized patient (SP) practice. The latest developments in online communication tools and the COVID-19 pandemic have promoted the needs for online clinical skills training objectively. However, existing commercial online platforms may not meet the requests for SP-based medical simulation. This paper described the methodology applied to develop a smartphone-based online platform for the management of clinical skills training and assessment with remote SPs, and aimed to determine whether this new platform is acceptable or useful through a pilot run in September 2020. The post-run survey including questionnaire inspired by technological acceptance model and determinants of the perceived ease of use was used to assess the acceptability and usefulness of the platform. Twenty four-year students of clinical medicine participated in the pilot study with twenty SPs and ten faculties. Data from the post-run survey showed that there was a general recognition that the platform is easy to use among all the users. Two questions regarding the usefulness of the platform showed significant differences between the SPs/faculties and the students. More SPs found the platform useful as a training method than the students did. The faculties showed more attempts than the students to use this platform for clinical skills training in the future. This smartphone-based online platform was widely accepted among the tested students, SPs and faculties, which meets the requests and challenges of the new era. It provides an effective approach for clinical skills training and assessment with remote SPs.

Doing public health differently: How can public health departments engage with local communities through social media interventions?

Objectives

This paper evaluates a collaborative intervention between public health professionals and local social media administrators, in which the social media site Facebook was used with a view to strengthening engagement with and, dissemination of, core messages and building trust and resilience within local communities during the COVID-19 pandemic.

Study design

A qualitative design was used, exploring the research question: how does collaboration between public health professionals and local social network group administrators create community engagement during a global crisis?

Methods

Fourteen semi-structured interviews were conducted with public health staff and online group administrators. Data was analysed using framework analysis.

Results

Collaboration between public health professionals and local group administrators created both opportunities and challenges. Local group administrators had wide reach and trust within the local community, but message credibility was enhanced through local authority involvement. Such collaborations contain inherent tensions due to perceived risks to social capital and independence but can be successful if receiving strong risk-tolerant support from the local authority. Findings are discussed in the context of Bourdieu's theory of social capital to examine how public health information can be delivered by trusted social media actors in communication tailored to the local community.

Conclusions

Social media provides new channels of communication for delivery of public health messages, enabling new ways of working which create long-term engagement and community building. Although the intervention was developed quickly in response to the COVID-19 pandemic, participants felt it could be mobilised to address a wider range of issues.

Investigating the Role of Goals and Motivation on Waste Separation Behavior Through the Lens of the Theory of Reasoned Goal Pursuit

Nowadays the prediction and change of waste-related behaviors represent a key topic for scholars and policy makers. The theoretical mainstays applied to waste separation behavior, such as the Theory of Planned Behavior (TPB), the Norm Activation Model and the Value Belief Norm, do not include the construct of goal in their formulation. Other goal-focused theories, such as the Goal Systems Theory (GST), lack applications on separation behavior. Recently, Ajzen and Kruglanski (2019) have proposed the Theory of Reasoned Goal Pursuit (TRGP) which combines TPB and GST. Considering TRGP has the potential to offer further insights on human behavior and, to our knowledge, there is no application of TRGP to recycling behavior yet, this paper analyses waste separation behavior of households in Maastricht and Zwolle (The Netherlands) under the lens of TRGP. Although waste separation behavior represents a kind of habitual behavior, this paper highlights the influence of goals and motivation on intention to separate waste. Furthermore, it offers some indications to promote behavior change and some suggestions for future research directions.

Results of a Multi-Disciplinary and Multi-Institutional Pilot Creating High-Yield Physics Educational Content (Hi-Phy)

Purpose

The quality of medical physics education is heterogenous across training programs, despite its importance in radiation oncology (RO) residency training. We present the results of a pilot series of free high-yield physics educational videos covering 4 topics chosen from the American Society for Radiation Oncology core curriculum.

Methods and materials

Scripting and storyboarding of videos were iterative processes performed by 2 ROs and 6 medical physicists, with animations created by a university broadcasting specialist. Current RO residents and those who had graduated after 2018 were recruited through social media and e-mail with an aim of 60 participants. Two validated surveys were adapted for use and were completed after each video as well as a final overall assessment. Content was released sequentially after completion of the survey instruments for each prior video. All videos were created and released within 1 year of project initiation with a duration of 9 to 11 minutes.

Results

There were 169 enrollees for the pilot from across the world, 211% of the targeted cohort size. Of these, 154 met eligibility criteria and received the first video. One hundred eight enrollees initiated the series and 85 completed the pilot, resulting in a 78% completion rate. Participants reported improved understanding and confidence applying the knowledge learned in the videos (median score 4 out of 5). All participants reported that the use of graphic animation improved understanding across all videos. Ninety-three percent agreed with a need for additional resources geared specifically toward RO residents and 100% would recommend these videos to other residents. Use metrics revealed the average watch time was 7 minutes (range, 6:17-7:15).

Conclusions

The high-yield educational physics video pilot series was successful in developing videos that were effective in teaching RO physics concepts.

Does digital transformation foster corporate social responsibility? Evidence from Chinese mining industry

Mining activities induce some social problems, such as polluted environments, the destruction of aquatic live, which have long been debated by scholars and practitioners. To mitigate this problem, underpinning dynamic capability view, our study explores whether the digital transformation (DT) affects corporate social responsibility (CSR) by using 1308 Chinese mining A-shared listed firms from 2010 to 2021, and how the potential relationship is moderated by environmental uncertainty (EU) and supply chain concentration (SCC). Applying fixed effects regressions, we find that DT fosters CSR in the mining industry, but CSR performance is weakened when DT processed at higher EU and SCC respectively. Our findings enrich the literature on CSR of mining industry and highlight that DT is an important driver that shapes CSR practice.

Longitudinal Relationships Between Interparental Conflict and Adolescent Depression: Moderating Effects of School Connectedness

The present study examined the association between interparental conflict and adolescent depression, and explored the moderating role of school connectedness in this association, in a Chinese context. Data were analyzed from 867 Chinese adolescents who completed the survey at 2 time points. Cross-lagged analyses indicated that interparental conflict in 7th grade adolescents significantly predicted depression in 8th grade, but adolescent depression in 7th grade was not a significant predictor of interparental conflict in 8th grade. In addition, there was a significant negative moderating effect of school connectedness, as high levels of school connectedness reduced the negative effect of interparental conflict on adolescent depression. Thus, the association between interparental conflict and adolescent depression has a unidirectional prediction. School connectedness can relieve the adverse effects of interparental conflict on adolescent depression.

Methods used to evaluate usability of mobile clinical decision support systems for healthcare emergencies: a systematic review and qualitative synthesis

Objective

The aim of this study was to determine the methods and metrics used to evaluate the usability of mobile application Clinical Decision Support Systems (CDSSs) used in healthcare emergencies. Secondary aims were to describe the characteristics and usability of evaluated CDSSs.

Materials and Methods

A systematic literature review was conducted using Pubmed/Medline, Embase, Scopus, and IEEE Xplore databases. Quantitative data were descriptively analyzed, and qualitative data were described and synthesized using inductive thematic analysis.

Results

Twenty-three studies were included in the analysis. The usability metrics most frequently evaluated were efficiency and usefulness, followed by user errors, satisfaction, learnability, effectiveness, and memorability. Methods used to assess usability included questionnaires in 20 (87%) studies, user trials in 17 (74%), interviews in 6 (26%), and heuristic evaluations in 3 (13%). Most CDSS inputs consisted of manual input (18, 78%) rather than automatic input (2, 9%). Most CDSS outputs comprised a recommendation (18, 78%), with a minority advising a specific treatment (6, 26%), or a score, risk level or likelihood of diagnosis (6, 26%). Interviews and heuristic evaluations identified more usability-related barriers and facilitators to adoption than did questionnaires and user testing studies.

Discussion

A wide range of metrics and methods are used to evaluate the usability of mobile CDSS in medical emergencies. Input of information into CDSS was predominantly manual, impeding usability. Studies employing both qualitative and quantitative methods to evaluate usability yielded more thorough results.

Conclusion

When planning CDSS projects, developers should consider multiple methods to comprehensively evaluate usability.

Patients' attitudes towards using a question prompt list in community pharmacies

OBJECTIVE

To explore patients' usage rate and perceived usefulness and benefits of a question prompt list (QPL) when collecting prescribed medication in community pharmacies.

METHODS

Data were collected in Swedish pharmacies using questionnaires and semi-structured interviews with patients. The Technology Acceptance Model (TAM) was used, and the outcomes were usage rate, factors impacting on use, and perceived ease of use, usefulness, and benefits of self-reported question-asking and self-perceived medication knowledge. Descriptive statistics and group comparisons were performed, and qualitative data were analyzed thematically with the TAM.

RESULTS

Out of 145 patients filling out the questionnaire, 72 (50.0%) reported they had used the QPL. Patients with new prescriptions and non-native Swedish speakers used the QPL more often (p = 0.03; p = 0.009, respectively). The QPL was quick to read (86.3%) and easy to understand (91.4%). Forty percent stated that they asked more questions, and self-reported users scored higher on self-perceived medication knowledge. In the interviews (n = 14), the QPL was described as an eye-opener as to what one could ask the pharmacist.

CONCLUSIONS

Patients were willing to use a QPL in community pharmacies.

PRACTICE IMPLICATIONS

A QPL in pharmacies might improve patients' engagement medication knowledge, as well as showcase the expertise of pharmacists.

Are we ready for hotel robots after the pandemic? A profile analysis

COVID-19 has changed many aspects of the hospitality and tourism industry, including technology-oriented and contactless solutions. Despite the increasing number of service companies using robots on their premises, most of the previous attempts and practices of adoption have remained unsuccessful. Prior research hints that socioeconomic factors could influence the successful adoption of these emerging technologies. Nevertheless, these studies ignore the role of profile factors and assume a homogenous response to using robots in service operations during the pandemic. Based on the theory of diffusion of innovation and a sample of 525 participants, this study investigates the differences in customers' attitudes, their level of involvement, and optimism for service robots as well as their intentions to use service robots in the five main areas of hotel operations (front desk, concierge, housekeeping, room service, and food and beverage) based on five profile factors (age, gender, income level, education, and purpose of trip). MANOVA tests show significant differences in all variables based on demographic factors; male, younger, more educated, higher income, and leisure travelers show more positive attitudes, higher involvement, optimism, and intention to use service robots across various hotel departments. In particular, mean scores were found to be smaller for the traditionally human-oriented functional areas of the hotel operations. We also clustered the participants based on their level of comfort and optimism about using service robots in hotels. Given the rapid changes in the service industry and the increasing adoption of service robots, this paper adds a much-needed contribution to the ongoing research on service robots in the service industry by investigating the impact of profile factors on guests' behavior towards service robots.

Algorithm-mediated social learning in online social networks

Human social learning is increasingly occurring on online social platforms, such as Twitter, Facebook, and TikTok. On these platforms, algorithms exploit existing social-learning biases (i.e., towards prestigious, ingroup, moral, and emotional information, or 'PRIME' information) to sustain users' attention and maximize engagement. Here, we synthesize emerging insights into 'algorithm-mediated social learning' and propose a framework that examines its consequences in terms of functional misalignment. We suggest that, when social-learning biases are exploited by algorithms, PRIME information becomes amplified via human-algorithm interactions in the digital social environment in ways that cause social misperceptions and conflict, and spread misinformation. We discuss solutions for reducing functional misalignment, including algorithms promoting bounded diversification and increasing transparency of algorithmic amplification.

Oral Health Outcome Measures: A Feasibility Evaluation

OBJECTIVES

Outcomes of oral health care must be measured and analysed to improve oral health care delivery, outcomes, and quality. This study aims to develop and test outcome measures for the needs of oral health organisers and explore their feasibility using clinical data.

METHODS

Based on the literature review and oral health advisory board, outcome measures for oral health care were identified, developed, and tested. Data from 425,000 clinical examinations were obtained from the clinical records of 8 public oral care providers in Finland.

RESULTS

The advisory board selected 7 outcome measures: 1 on oral self-care, 2 on periodontitis, 3 on caries, and 1 on missing teeth. A large variation was found in the diagnostic and data entry practices of these outcome measures. The coverage of caries and missing teeth entries was good, but the quality of initial and remineralised caries entries was questionable. The caries and missing teeth measures show statistically significant differences amongst some providers.

CONCLUSIONS

The measures "new cavitated caries surfaces," "cavity-free clinical examinations," and "the change in the missing value" were evaluated as feasible. The results of these measures provided insight about the effectiveness of oral care and enabled the comparison between the providers and age groups. Statistically significant differences between the providers in the measures imply potential possibilities for providers to learn from each other.

Older Adults With Functional Limitations and Their Use of Telehealth During COVID-19

We investigated the association between functional limitations and telehealth use among older Medicare beneficiaries in 2020. We use logistic regression models to estimate associations between functional limitations and the use of technological tools (i.e., computers, Internet, telehealth). We consider Internet use and informal technological support as moderators for telehealth use. Respondents (N = 3151; Mage = 78.31) with more functional limitations were more likely to use video-based telehealth. Net of functional limitations, those with a consistent Internet use were more likely to use emails/texts/portal messages to communicate with a healthcare provider. Further, more functional limitations were associated with a higher probability of using emails/texts/portal messages, but only among respondents who received informal technological support. Healthcare access may have been more difficult for older adults with functional limitations during the COVID-19 pandemic, especially for those with little prior experience with the Internet, or those without friends/family to provide technological support.

The Development and Validation of a Psychometric Tool to Assess Behavioral Factors Impacting Personal Dosimeter Use among Medical Radiation Workers

ABSTRACT

Personal dosimeters are used by medical radiation workers (MRWs) to monitor their radiation dose from external sources and comply with radiation safety guidelines. Nevertheless, there is evidence of inconsistent use of the devices among MRWs. Behavioral factors influencing the use of personal dosimeters have never been explored. Using established behavioral models, we aimed to develop a psychometric tool to measure the behavioral factors influencing dosimeter use and establish its feasibility, reliability, and validity. A 37-item tool was developed based on a qualitative study and review of the literature. The content relevancy was assessed by six field experts before it was piloted and re-tested on MRWs. The construct validity of the tool was analyzed using exploratory factor analysis to confirm its psychometric properties. Face validation was performed by academicians, field experts, and MRWs to enhance the tool's readability. The 37 items in the tool belonged to five constructs in the early phase. However, the validation study revealed a reliable 27 item tool with seven constructs, namely: "Attitude," "Social factors," "Ability to perform if facilitated," "Ability to overcome shortcomings," "Self-efficacy," "Complexity," and "Perceived usefulness." The item-construct validity index of accepted items was >0.83, and Cronbach's alpha for each construct ranged between 0.70 to 0.96, while factor loading for each item was between 0.723 to 0.963. All results were considered "good" and "excellent." The new tool appears to be valid, reliable, and feasible to measure behavioral factors influencing personal dosimeter use among MRWs, which is helpful to facilitate the planning of interventions to improve behaviors in occupational radiation monitoring.

Exploring rumor behavior during the COVID-19 pandemic through an information processing perspective: The moderating role of critical thinking

In the midst of the pervasive disruption caused by the proliferation of rumors, it is unclear how individuals react to such information. Guided by the SOR theory (Stimuli-Organism-Response), our study investigates the association between different information sources (stimuli), emotions experienced by individuals (organism), and resulting rumor behaviors such as sharing and refuting (response). Furthermore, we examine the moderating role of individual critical thinking in this process. Using the COVID-19 pandemic as a study scenario, we collected questionnaire data from 4588 respondents. Our results reveal a large positive association between pandemic-related information and feelings of fear. Additionally, a medium negative correlation between fear and rumor sharing was observed while a moderate positive correlation between fear and rumor refuting was identified. Moreover, we found that individual critical thinking abilities can effectively moderate the relationship between fear and online COVID-19-related information and strengthen the link between fear and rumor sharing while weakening the link between fear and rumor refuting. Additionally, our study indicates that an individual's fear plays a mediating role in the relationship between information sources and rumor behavior. Our findings shed light on the information processing mechanisms underlying rumor behaviors and yield practical and policy implications for managing them.

Nursing informatics competence profiles and perceptions of health information system usefulness among registered nurses: A latent profile analysis

AIMS

To identify different nursing informatics competence (NIC) profiles in nurses, examine the factors associated with profile memberships and examine the associations of the derived profiles with the nurses' perception of the usefulness of a health information system (HIS).

DESIGN

A cross-sectional study.

METHODS

A sample of 3610 registered nurses responded to a nationwide survey in March 2020. A latent profile analysis was performed to identify NIC profiles based on three competence areas: nursing documentation, working in digital environment, and ethics and data protection. A multinomial logistic regression was carried out to examine the associations of demographic and background variables with the profile membership. Linear regression analyses were carried out to examine the association between the profile membership and perceived HIS usefulness.

RESULTS

Three NIC profiles were identified and labelled as low, moderate and high competence groups. A younger age, recent graduation year, sufficient orientation and high-rated proficiency as an HIS user were associated with nurses belonging to a high or moderate competence group relative to a low competence group. Competence group membership was associated with perceived HIS usefulness. The high competence group consistently expressed the highest usefulness of the HIS and the low competence group the lowest.

CONCLUSION

Tailored training and support should be provided for nurses with different levels of informatics competence, thereby facilitating their ability to respond to increasingly digitalized work. This could contribute to higher usefulness of the HIS in terms of supporting the nurses' work tasks and promoting the quality of care.

IMPACT

This was the first study exploring latent profiles of informatics competence in nurses. Insights from this study are useful for nursing management to identify different competence profiles of their employees, provide support and training to meet their needs, and promote the successful use of an HIS.

Parental and Child Factors Associated With Internet Addiction in Children

BACKGROUND

Internet addiction has negative effects on psychological development, interpersonal relationships, and social adaptation in 10-year-old elementary school students.

OBJECTIVE

This study aimed to identify parental and child characteristics related to Internet addiction in lower-grade elementary school children.

METHODS

This study used a secondary data analysis. Data from the tenth Panel Study on Korean Children were used. In total, 1224 ten-year-old elementary school students were included in the analysis. The questionnaire included general, parental, and child characteristics.

RESULTS

Of all child participants, 18.5% were in the high-risk group for Internet addiction. Lower paternal and maternal spousal satisfaction, maternal education level of high school graduate or lower, and greater permissive parenting by the mother were associated with higher odds of Internet addiction among their children. Moreover, boys and children who spent more than an hour per day without adults showed higher odds of Internet addiction.

CONCLUSIONS

The results of this study indicate that the implementation of an intervention that improves parenting and family relationships and positively changes the environment in which children are brought up is necessary.

Financial crisis early warning of Chinese listed companies based on MD&A text-linguistic feature indicators

Nowadays, the international situation is severe and complex, and the structural issues within the Chinese economy are prominent. Consequently, the financial risks faced by Chinese listed companies continue to escalate. Hence, it is of great practical significance to furnish effective early warnings for financial crises in listed companies. In this paper, we first employ web crawler technology and natural language processing technology to assess four text-linguistic features in the Management Discussion and Analysis (MD&A) section of the annual financial reports of listed companies in China from 2011 to 2020. These features are text tone, forward-looking, readability and similarity. Subsequently, we combine these features with traditional financial indicators and explore thirteen mainstream machine learning models to comparatively analyze their effectiveness in predicting financial crises in listed companies. The empirical findings of this research reveal that MD&A text readability and similarity indicators contribute valuable incremental information to prediction models, whereas text tone and forward-looking indicators exhibit the opposite effect. The latter two indicators can be manipulated more effortlessly by management, as this study's empirical findings indicate no evidence of their contributions in incremental informational value. In fact, the forward-looking indicator even introduces additional noise to the prediction. Finally, by comparing the early warning effects of thirteen machine learning models, it is found that RF, Bagging, CatBoost, GBDT, XGBoost and LightGBM models maintain stable and accurate sample recognition ability. In general, this paper constructs a more effective financial crisis early warning model by exploring the MD&A text-linguistic feature indicators, thereby offering a fresh research perspective for further investigations in this field.

Celebrity Identification and Reasoned Action: An Integrative Model of the Relationship Between Media Use and Breast Cancer Screening Intention

This study investigates the relationship between media use and breast cancer screening intentions by integrating the celebrity identification model and the theory of reasoned action. It tests an integrative model with survey data from 315 U.S. adult women. The study found that media use for breast cancer information was positively associated with parasocial interaction (PSI) and identification with celebrities who have or have had breast cancer; PSI was positively associated with attitudes, descriptive and injunctive norms in breast cancer screening, while identification with celebrities was positively associated with descriptive norms; attitudes, injunctive norms and descriptive norms were positively associated with breast cancer screening intentions. The study supports the mediating effect of PSI, identification, attitudes, and descriptive and injunctive norms on the association between media use and breast cancer prevention intentions.

Digital entrepreneurship from cellular data: How omics afford the emergence of a new wave of digital ventures in health

Data has become an indispensable input, throughput, and output for the healthcare industry. In recent years, omics technologies such as genomics and proteomics have generated vast amounts of new data at the cellular level including molecular, structural, and functional levels. Cellular data holds the potential to innovate therapeutics, vaccines, diagnostics, consumer products, or even ancestry services. However, data at the cellular level is generated with rapidly evolving omics technologies. These technologies use scientific knowledge from resource-rich environments. This raises the question of how new ventures can use cellular-level data from omics technologies to create new products and scale their business. We report on a series of interviews and a focus group discussion with entrepreneurs, investors, and data providers. By conceptualizing omics technologies as external enablers, we show how characteristics of cellular-level data negatively affect the combination mechanisms that drive venture creation and growth. We illustrate how data characteristics set boundary conditions for innovation and entrepreneurship and highlight how ventures seek to mitigate their impact.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12525-023-00669-w.

Are ride-hailing services safer than taxis? A multivariate spatial approach with accommodation of exposure uncertainty

Despite many research efforts on ride-hailing services and taxis, limited studies have compared the safety performance of the two modes. A major challenge is the need for reliable mode-specific exposure data to model their safety outcomes. Moreover, crash frequencies of the two modes by injury severities tend to be spatially and inherently correlated. To fully address these issues, this study proposes a novel multivariate conditional autoregressive model considering measurement errors in mode-specific exposures (MVCARME). More specially, a classical measurement error structure accommodates the uncertainty of estimated mode-specific exposures, and a multivariate spatial specification is adopted to capture potential spatial and inherent correlations. The model estimation is accelerated by an integrated nest Laplace approximation method. The census tracts in the city of Chicago are set as the spatial analysis unit. The mode-specific exposures (vehicle-mile-traveled) in each census tract are estimated by trip assignments using ride-hailing and taxi trip data in 2019. The modeling results indicate that both ride-hailing crashes and taxi crashes are positively associated with transportation factors (e.g., vehicle-mile-traveled, mode-specific vehicle-mile-traveled, and traffic signal numbers), land use factors (i.e., number of educational and alcohol-related sites), and demographic factors (e.g., median household income, transit ratio, and walk ratio). By comparison, the proposed model outperforms the others (i.e., negative binomial models and multivariate conditional autoregressive model) by yielding the lowest deviance information criterion (DIC), Watanabe-Akaike information criterion (WAIC), mean absolute error (MAE), and root-mean-square error (RMSE). According to the results of t-tests, ride-hailing services are found to be prone to a higher risk of minor injury crashes compared with taxis, despite no significant difference between the risks of severe injury crashes. Methodologically, this study adds a robust safety evaluation approach for comparing crash risks of different modes to the literature. At the same time, practically, it provides researchers, practitioners, and policy-makers insights into the safety management of various mobility alternatives.

What are the roles of eHealth literacy and empowerment in self-management in an eHealth care context? A cross-sectional study

AIMS

To examine the relationship among eHealth literacy, empowerment and self-management and the mediating effects of empowerment in diabetic kidney disease (DKD) patients in the eHealthcare context.

BACKGROUND

Self-management is an essential aspect of healthcare in delaying disease progression for DKD. In the eHealthcare era, health services providing self-management are transforming. The ability and confidence of patients to use eHealth services is a critical issue that impacts the effectiveness of self-management, but little is known about the role of eHealth literacy and empowerment in self-management.

DESIGN

A cross-sectional study guided by the STROBE.

METHODS

Overall, 127 Taiwanese patients were enrolled using convenience sampling. Data collection used structured questionnaires and chart reviews. Multiple regression was used to infer self-management predictors, and SPSS PROCESS macro and bootstrapping verified the mediating effects.

RESULTS

Empowerment and eHealth literacy both showed significant positive correlations with self-management. Empowerment was the main predictor of self-management and had a complete mediating effect between eHealth literacy and self-management.

CONCLUSION

Increasing patients' eHealth literacy can improve empowerment and prevent health inequality issues. Healthcare providers should consider improving patients' eHealth literacy to enhance their self-management.

RELEVANCE TO CLINICAL PRACTICE

Healthcare service systems need to create user-friendly eHealthcare environments, and healthcare professionals can provide multifaceted instructions that fit patients' eHealth literacy levels to enhance their motivation and confidence in disease care, thus cultivating positive self-management behaviours.

IMPACT

The popularity of eHealthcare services aimed at promoting self-management behaviours is increasing. However, the level of eHealth literacy is an essential factor that affects the effectiveness of self-management in the healthcare environment. In addition, empowerment is a major critical influence factor of self-management and a completely mediating variable between self-management and eHealth literacy. Consequently, healthcare providers should consider promoting patients' eHealth literacy to empower people using eHealthcare services for implementing self-management.

REPORTING METHOD

The Strengthening the Reporting of Observational Studies in cross-sectional studies (STROBE) checklist was used to ensure comprehensive reporting.

PATIENT OR PUBLIC CONTRIBUTION

Patients were diagnosed with DKD in the study hospital. Physicians and case managers transferred patients to research assistants who screened them for the inclusion criteria and invited them to participate in this study if they met the requirements. After participants signed informed consent, the research nurse encouraged participants to respond to the research questionnaire face to face.

Understanding unmet medical needs through medical crowdfunding in China

OBJECTIVES

Online medical crowdfunding has gained popularity in recent years in China. The objective of this study was to identify unmet medical needs in the public healthcare system through analysis of Chinese medical crowdfunding data.

STUDY DESIGN

Text information extraction and statistical analysis based on large-scale data.

METHODS

From 19 June 2011 to 15 March 2020, data from 30,704 medical crowdfunding projects were collected from Tencent GongYi, which is one of the largest Chinese medical crowdfunding platforms. Text mining methods were used to extract data on the medical conditions and locations of the applicants of medical crowdfunding. In addition, 125 medical crowdfunding projects initiated by leukaemia patients in Chongqing and Nanyang were further investigated through manual data extraction, and the factors impacting the fundraising goals were explored using a generalised linear model.

RESULTS

The most common conditions using medical crowdfunding to raise funds were as follows: cancer (31.87%), chronic conditions (18.14%), accidental injury (7.80%) and blood system-related conditions (7.75%). Treatments for cancer and blood system-related conditions are expensive and have serious long-term impacts on the lives of patients. Results showed that the cities of Nanyang and Chongqing had the largest number of crowdfunding projects.

CONCLUSIONS

This study found that the medical conditions that prompted individuals to apply for crowdfunding were those with long treatment cycles, complexities and expensive medical or non-medical costs. Furthermore, discrepancies in health insurance policies between different regions and residents seeking treatments outside their insurance locations were also important factors that triggered medical crowdfunding applications. Adjusting health insurance policies accordingly may improve the efficiency of utilising health insurance resources and reduce the financial burden on patients.

The Development of Game-Based Digital Mental Health Interventions: Bridging the Paradigms of Health Care and Entertainment

Game elements are increasingly used to improve user engagement in digital mental health interventions, and specific game mechanics may yield therapeutic effects per se and thereby contribute to digital mental health intervention efficacy. However, only a few commercial game-based interventions are available. We suggest that the key challenge in their development reflects the tension between the 2 underlying paradigms, health care and entertainment, which have disparate goals and processes in digital development. We describe 3 approaches currently used to negotiate the 2 paradigms: the gamification of health care software, designing serious games, and purpose shifting existing entertainment games. We advanced an integrative framework to focus attention on 4 key themes in intervention development: target audience, engagement, mechanisms of action, and health-related effectiveness. On each theme, we show how the 2 paradigms contrast and can complement each other. Finally, we consider the 4 interdependent themes through the new product development phases from concept to production. Our viewpoint provides an integrative synthesis that facilitates the research, design, and development of game-based digital mental health interventions.