51
|
Boggiss AL, Consedine NS, Hopkins S, Silvester C, Jefferies C, Hofman P, Serlachius AS. A Self-Compassion Chatbot to Improve the Wellbeing of Adolescents with Type 1 Diabetes During the COVID-19 Pandemic: What do Adolescents and their Healthcare Professionals Want? JMIR Diabetes 2023; 8:e40641. [PMID: 36939680 PMCID: PMC10166132 DOI: 10.2196/40641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 11/08/2022] [Accepted: 01/30/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Prior to the coronavirus (COVID-19) pandemic, adolescents with type 1 diabetes (T1D) already experienced far greater rates of psychological distress than their peers. With the pandemic further challenging mental health and increasing the barriers to maintaining optimal diabetes self-management, it is vital this population has access to remotely deliverable, evidence-based interventions to improve psychological and diabetes outcomes. Chatbots, defined as digital conversational agents, offer these unique advantages, as well as the ability to engage in empathetic and personalized conversations 24/7. Building on previous work developing a self-compassion program for adolescents with T1D, a self-compassion chatbot was developed for adolescents with T1D to address these concerns. However, the acceptability and potential clinical usability of a chatbot to deliver self-compassion coping tools to adolescents with T1D remained unknown. OBJECTIVE This qualitative study was designed to evaluate the acceptability and potential clinical utility of a novel self-compassion chatbot (called 'COMPASS') among adolescents aged 12 to 16 years with T1D and their diabetes healthcare professionals. METHODS Potential adolescent participants were recruited from previous participant lists, and online and in-clinic study flyers, whereas healthcare professionals were recruited from clinic emails and diabetes research special interest groups. Qualitative Zoom interviews exploring views on a newly developed self-compassion chatbot were conducted with 19 adolescents (in 4 focus groups), and 11 diabetes healthcare professionals (in 2 focus groups and 6 individual interviews), from March to April 2022. Transcripts were analyzed using directed content analysis to examine the features and content of greatest importance to both groups. RESULTS Adolescents were broadly representation of the youth population living with T1D in Aotearoa (58% female, 68% Aotearoa New Zealand European, 11% Māori). Healthcare professionals represented a range of disciplines including Diabetes Nurse Specialists (n = 3), Health Psychologists (n = 3), Dieticians (n = 3), and Endocrinologists (n = 2). Findings offer early insight into what adolescents with T1D and their healthcare professionals see as shared advantages of COMPASS and desired future additions, such as personalization (mentioned by all 19 adolescents), self-management support (mentioned by 13 of 19 adolescents), clinical utility (mentioned by all 11 healthcare professionals), and breadth and flexibility of tools (mentioned by 10 of 11 healthcare professionals). CONCLUSIONS Early data suggest that a self-compassion chatbot for adolescents with T1D is acceptable, relevant to common difficulties, and offers clinical utility during the COVID-19 pandemic. However, shared desired features amongst both groups, including problem-solving and integration with diabetes technology to support self-management, creating a safe peer-to-peer sense of community, and broadening the representation of different cultures, lived experience stories, and diabetes challenges, could further improve the potential of the chatbot. Based on these findings, the COMPASS chatbot is currently being improved to be tested in a future feasibility study. CLINICALTRIAL
Collapse
Affiliation(s)
- Anna Lynette Boggiss
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Level 3, Building 507, 22-30 Park Avenue, Grafton, Auckland, NZ
| | - Nathan Sacha Consedine
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Level 3, Building 507, 22-30 Park Avenue, Grafton, Auckland, NZ
| | - Sarah Hopkins
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Level 3, Building 507, 22-30 Park Avenue, Grafton, Auckland, NZ
| | | | - Craig Jefferies
- Starship Children's Health, Auckland City Hospital, Auckland, NZ
| | - Paul Hofman
- Liggins Institute, University of Auckland, Auckland, NZ
| | - Anna Sofia Serlachius
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Level 3, Building 507, 22-30 Park Avenue, Grafton, Auckland, NZ
| |
Collapse
|
52
|
Mavragani A, Yan RJ, Harkin LJ, Katz D, Stevenson C, Mehta V, Giles E, Talbot C, Gooch D, Bennasar M, Self T, Nuseibeh B, Price B. Digital Intervention in Loneliness in Older Adults: Qualitative Analysis of User Studies. JMIR Form Res 2023; 7:e42172. [PMID: 36705962 PMCID: PMC9919429 DOI: 10.2196/42172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 11/18/2022] [Accepted: 12/01/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Loneliness is a significant well-being issue that affects older adults. Existing, commonly used social connection platforms do not contain facilities to break the cognitive cycle of loneliness, and loneliness interventions implemented without due processes could have detrimental effects on well-being. There is also a lack of digital technology designed with older adults. OBJECTIVE We aimed to iteratively design a user-centered smartphone app that can address loneliness in older adults. The aim of this study was to investigate the loneliness-related psychological processes that our conceptual smartphone app promotes. We also identified the emergent needs and concerns that older adults raised regarding the potential benefits and detriments of the app. METHODS We used technology probes to elicit older adults' reflections on the concept of using the app in 2 studies as follows: concept focus groups (n=33) and concept interviews (n=10). We then conducted a prototype trial with 1 week of use and follow-up interviews (n=12). RESULTS Thematic analysis explored the experiences and emergent challenges of our app through the design process. This led to the development of 4 themes as follows occurring in all 3 qualitative data sets: reflection on a digital social map is reassuring; app features encourage socializing; the risk of compounding loneliness; and individuals feel more control with mutual, socially beneficial activities. CONCLUSIONS Smartphone apps have the potential to increase older adults' awareness of the richness of their social connections, which may support loneliness reduction. Our qualitative approach to app design enabled the inclusion of older adults' experiences in technology design. Thus, we conclude that the older adults in our study most desired functionalities that can support mutual activities and maintain or find new connections rather than enable them to share an emotional state. They were wary of the app replacing their preferred in-person social interaction. Participants also raised concerns about making the user aware of the lack of support in their social network and wanted specific means of addressing their needs. Further user-centered design work could identify how the app can support mutual activities and socializing.
Collapse
Affiliation(s)
| | - Ronnie Jieru Yan
- Department of Psychology, Nottingham Trent University, Nottingham, United Kingdom
| | - Lydia Jo Harkin
- Department of Psychology, Nottingham Trent University, Nottingham, United Kingdom
| | - Dmitri Katz
- Computing and Communications, The Open University, Milton Keynes, United Kingdom
| | - Clifford Stevenson
- Department of Psychology, Nottingham Trent University, Nottingham, United Kingdom
| | - Vikram Mehta
- Computing and Communications, The Open University, Milton Keynes, United Kingdom
| | - Emilie Giles
- Graphic Design, School of Arts and Communication, Arts University Bournemouth, Bournemouth, United Kingdom
| | - Catherine Talbot
- Department of Psychology, Bournemouth University, Bournemouth, United Kingdom
| | - Daniel Gooch
- Computing and Communications, The Open University, Milton Keynes, United Kingdom
| | - Mohamed Bennasar
- Computing and Communications, The Open University, Milton Keynes, United Kingdom
| | - Tara Self
- Department of Psychology, Nottingham Trent University, Nottingham, United Kingdom
| | - Bashar Nuseibeh
- Computing and Communications, The Open University, Milton Keynes, United Kingdom.,Lero - The Irish Software Research Centre, University of Limerick, Limerick, Ireland
| | - Blaine Price
- Computing and Communications, The Open University, Milton Keynes, United Kingdom
| |
Collapse
|
53
|
Mavragani A, Matejko B, Juza A, Kieć-Wilk B, Krzyżowska S, Cohen O, Da Silva J, Lushchyk M, Malecki MT, Klupa T. Improvement of Selected Psychological Parameters and Quality of Life of Patients With Type 1 Diabetes Mellitus Undergoing Transition From Multiple Daily Injections and Self-Monitoring of Blood Glucose Directly to the MiniMed 780G Advanced Hybrid Closed-Loop System: Post hoc Analysis of a Randomized Control Study. JMIR Form Res 2023; 7:e43535. [PMID: 36692945 PMCID: PMC9906310 DOI: 10.2196/43535] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 12/13/2022] [Accepted: 12/13/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND While introducing new technologies and methods of treatment for type 1 diabetes mellitus (T1DM), it seems essential to monitor whether modern technologies in diabetes treatment may improve the psychological and emotional status of patients. OBJECTIVE This study aims to assess the baseline psychological parameters of patients with T1DM during investigation of the direct transition from multiple daily injections (MDI) and self-monitoring of blood glucose (SMBG) to the MiniMed 780G advanced hybrid closed-loop (AHCL) system and to evaluate changes in the psychological well-being and quality of life (QoL) after the transition in these individuals versus the control group. METHODS The trial was a 2-center, randomized controlled, parallel group study. In total, 41 patients with T1DM managed with MDI or SMBG were enrolled and randomized either to the AHCL or the MDI+SMBG group. Of these, 37 (90%) participants (mean age 40.3 years, SD 8.0 years; mean duration of diabetes 17.3, SD 12.1 years; mean hemoglobin A1c [HbA1c] 7.2%, SD 1.0%) completed the study (AHCL: n=20, 54%; MDI+SMBG: n=17, 46%). Psychological parameters (level of stress, coping mechanisms, level of anxiety, self-efficacy level, acceptance of illness, locus of control of illness, life satisfaction, QoL) were measured at baseline and at the end of the study using 10 psychological questionnaires. RESULTS At baseline, the general level of stress of the examined patients was higher than in the general healthy Polish population (P=.001), but coping strategies used in stressful situations were significantly more effective and the level of self-efficacy (P<.001) was much higher than in the general population. The patients in this study accepted their illness more than patients with diabetes from the general Polish population (P<.001), but they felt that their health does not depend on them compared to the general population (P<.001). The overall life satisfaction was similar to that of the general population (P=.161). After 3 months from transition, the AHCL group reported an increase in 4 scales of the QoL-feeling well (P=.042), working (P=.012), eating as I would like (P=.011), and doing normal things (P=.034)-in comparison to the control group, where no significant change occurred. The level of both state anxiety and trait anxiety decreased in the AHCL group: State-Trait Anxiety Inventory (STAI) X1 scores (P=.009), STAI X1 stens (P=.013), and STAI X2 scores (P=.022). The AHCL group became more emotion oriented in stressful situations (Coping Inventory for Stressful Situations [CISS] E; P=.043) and significantly less self-blaming after 3 months of the study (P=.020). CONCLUSIONS The results indicate that the patients who decided to take part in the transition study were characterized by higher levels of stress than the general healthy population but had better coping strategies and self-efficacy. Furthermore, transitioning from MDI+SMBG treatment to the AHCL in patients naive to technology may significantly improve psychological well-being and QoL within 3 months. The rapidity of these changes suggests that they may be related to the significant improvement in glycemic outcomes but also significantly less burdened diabetes self-management. TRIAL REGISTRATION ClinicalTrials.gov NCT04616391; https://clinicaltrials.gov/ct2/show/NCT04616391.
Collapse
Affiliation(s)
| | - Bartłomiej Matejko
- Department of Metabolic Diseases, Jagiellonian University Medical College, Krakow, Poland.,Hospital University in Krakow, Krakow, Poland
| | - Anna Juza
- Clinical Provincial Hospital of Frederic Chopin No 1 in Rzeszów, Rzeszów, Poland.,College of Medical Sciences, University of Rzeszow, Rzeszow, Poland
| | | | | | - Ohad Cohen
- Medtronic, Northridge, California, CA, United States
| | - Julien Da Silva
- Medtronic International Trading Sàrl, Tolochenaz, Switzerland
| | - Maxim Lushchyk
- Belarusian Medical Academy of Postgraduate Education, Minsk, Belarus
| | - Maciej T Malecki
- Department of Metabolic Diseases, Jagiellonian University Medical College, Krakow, Poland.,Hospital University in Krakow, Krakow, Poland
| | - Tomasz Klupa
- Department of Metabolic Diseases, Jagiellonian University Medical College, Krakow, Poland.,Hospital University in Krakow, Krakow, Poland
| |
Collapse
|
54
|
Du Y, Roberts P, Liu W. Facilitators and Barriers of Tai Chi Practice in Community-Dwelling Older Adults: Qualitative Study. Asian Pac Isl Nurs J 2023; 7:e42195. [PMID: 36720122 PMCID: PMC9976991 DOI: 10.2196/42195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 12/31/2022] [Accepted: 01/03/2023] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Numerous studies have documented the beneficial effects of Tai Chi on a variety of health outcomes, especially in older adults. However, only few studies have examined how to improve the practice and adherence of this Asian-originated exercise among older adults in Western countries. OBJECTIVE This study aimed to identify facilitators and barriers to Tai Chi practice and adherence in community-dwelling older adults. METHODS This study analyzed the qualitative data collected from 13 participants (mean age 62.0, SD 10.3) at the end of a 15-week randomized controlled trial conducted at a day activity senior center. Semistructured interviews were conducted, recorded, and transcribed; and the data were analyzed using inductive thematic analysis. RESULTS Four themes emerged: perceived benefit, threats, facilitators, and barriers. Perceived threats (eg, aging and side effects of medications) and perceived benefits of Tai Chi (eg, balance) inspired participants' engagement in Tai Chi exercise. On the other hand, barriers to Tai Chi practice and adherence included instructor's teaching style, the complexity of Tai Chi postures and movements, and existing health conditions (eg, hip problems). In essence, factors like Tai Chi class availability, family and peer support, as well as practicing Tai Chi with music may facilitate Tai Chi exercise adherence. CONCLUSIONS The study findings could provide valuable information to health professionals, such as nurses and physical therapists, in developing and implementing effective Tai Chi programs in care plans. Considering health conditions, tailoring Tai Chi exercise instruction styles, encouraging social and peer support, and incorporating music may promote Tai Chi practice and adherence.
Collapse
Affiliation(s)
- Yan Du
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Penny Roberts
- Department of Music, Loyola University, New Orleans, LA, United States
| | - Wei Liu
- School of Health Professionals, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| |
Collapse
|
55
|
Weser V, Opara I, Budge M, Duncan L, Fernandes CSF, Hussett-Richardson S, Sands B, Hieftje K. Pilot-testing a Multiplayer HIV and Sexually Transmitted Infection Prevention Video Game Intervention for Black Adolescent Girls: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e43666. [PMID: 36689272 PMCID: PMC9903186 DOI: 10.2196/43666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 12/12/2022] [Accepted: 12/13/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Black adolescent girls aged between 14 and 19 years are more likely than White girls to be diagnosed with a sexually transmitted infection (STI). As STI diagnosis is associated with an increase in the risk for HIV acquisition, an early intervention specifically tailored to Black adolescent girls is warranted. A web-based video game intervention has the potential to reach this demographic. Because studies of social and behavioral determinants of disease demonstrate the protective role of peer group structures on individual outcomes, a multiplayer game can facilitate opportunities to exchange and evaluate information, learn social norms, develop behavioral skills, and allow peers to influence attitudes and behavior. No prior research has examined the feasibility of a web-based multiplayer game intervention for this population. OBJECTIVE This study describes the protocol for a randomized controlled trial (RCT) pilot-testing the feasibility, acceptability, and limited efficacy of a multiplayer game-based intervention for increasing HIV and STI testing and condom use in Black adolescent girls. METHODS We enrolled 79 Black adolescent girls aged 14 to 19 years residing in the United States into a 2-arm parallel RCT. The intervention is a theory-based, community-informed, multiplayer game that can be played with peers on the web using videoconferencing software. The goal of the game is to empower Black adolescent girls to make healthy decisions regarding dating, relationships, and sex, thus reducing HIV and STI infection. Control condition participants received a list of resources after playing a time and attention control game. All study procedures were conducted via the internet. We conveniently sampled Black adolescent girls using web-based advertisements. Study assessments occurred at enrollment, 1 week, 1 month, and 4 months after enrollment. The primary outcome of this study is increased HIV and STI testing by Black adolescent girls. Secondary outcomes include increased condom use, self-efficacy to use condoms, positive attitudes toward condom use, intentions, harm perceptions, HIV and STI and pre-exposure prophylaxis knowledge, positive sexual norms, sexual communication with partners, and reduced incidence of sexual risk behaviors associated with HIV and STI transmission. Secondary outcomes also included assessment of intervention feasibility and acceptability. RESULTS From February to April 2022, a total of 79 Black adolescent girls were enrolled, with 40 (51%) having been randomized into the intervention condition and 39 (49%) into the control condition. At baseline, participant ages ranged from 14 to 19 (mean 16.4, SD 1.23) years. CONCLUSIONS Web-accessible game interventions overcome common impediments of face-to-face interventions presenting a unique opportunity to reach Black adolescent girls and improve their sexual health and self-efficacy. Trial data will provide information about the limited efficacy of the intervention and inform future web-based studies and a larger RCT aimed at improving the sexual health of Black adolescent girls. TRIAL REGISTRATION ClinicalTrials.gov NCT04108988; https://clinicaltrials.gov/ct2/show/NCT04108988. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/43666.
Collapse
Affiliation(s)
| | - Ijeoma Opara
- Yale School of Public Health, New Haven, CT, United States
| | - Mariana Budge
- Yale School of Medicine, New Haven, CT, United States
| | - Lindsay Duncan
- Department of Kinesiology and Physical Education, McGill University, Montreal, QC, Canada
| | | | | | - Brandon Sands
- Yale School of Medicine, New Haven, CT, United States
| | | |
Collapse
|
56
|
Mavragani A, Kimura D, Kosugi A, Shinkawa K, Takase T, Kobayashi M, Yamada Y, Nemoto M, Watanabe R, Ota M, Higashi S, Nemoto K, Arai T, Nishimura M. Screening of Mild Cognitive Impairment Through Conversations With Humanoid Robots: Exploratory Pilot Study. JMIR Form Res 2023; 7:e42792. [PMID: 36637896 PMCID: PMC9883738 DOI: 10.2196/42792] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 11/23/2022] [Accepted: 12/01/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND The rising number of patients with dementia has become a serious social problem worldwide. To help detect dementia at an early stage, many studies have been conducted to detect signs of cognitive decline by prosodic and acoustic features. However, many of these methods are not suitable for everyday use as they focus on cognitive function or conversational speech during the examinations. In contrast, conversational humanoid robots are expected to be used in the care of older people to help reduce the work of care and monitoring through interaction. OBJECTIVE This study focuses on early detection of mild cognitive impairment (MCI) through conversations between patients and humanoid robots without a specific examination, such as neuropsychological examination. METHODS This was an exploratory study involving patients with MCI and cognitively normal (CN) older people. We collected the conversation data during neuropsychological examination (Mini-Mental State Examination [MMSE]) and everyday conversation between a humanoid robot and 94 participants (n=47, 50%, patients with MCI and n=47, 50%, CN older people). We extracted 17 types of prosodic and acoustic features, such as the duration of response time and jitter, from these conversations. We conducted a statistical significance test for each feature to clarify the speech features that are useful when classifying people into CN people and patients with MCI. Furthermore, we conducted an automatic classification experiment using a support vector machine (SVM) to verify whether it is possible to automatically classify these 2 groups by the features identified in the statistical significance test. RESULTS We obtained significant differences in 5 (29%) of 17 types of features obtained from the MMSE conversational speech. The duration of response time, the duration of silent periods, and the proportion of silent periods showed a significant difference (P<.001) and met the reference value r=0.1 (small) of the effect size. Additionally, filler periods (P<.01) and the proportion of fillers (P=.02) showed a significant difference; however, these did not meet the reference value of the effect size. In contrast, we obtained significant differences in 16 (94%) of 17 types of features obtained from the everyday conversations with the humanoid robot. The duration of response time, the duration of speech periods, jitter (local, relative average perturbation [rap], 5-point period perturbation quotient [ppq5], difference of difference of periods [ddp]), shimmer (local, amplitude perturbation quotient [apq]3, apq5, apq11, average absolute differences between the amplitudes of consecutive periods [dda]), and F0cov (coefficient of variation of the fundamental frequency) showed a significant difference (P<.001). In addition, the duration of response time, the duration of silent periods, the filler period, and the proportion of fillers showed significant differences (P<.05). However, only jitter (local) met the reference value r=0.1 (small) of the effect size. In the automatic classification experiment for the classification of participants into CN and MCI groups, the results showed 66.0% accuracy in the MMSE conversational speech and 68.1% accuracy in everyday conversations with the humanoid robot. CONCLUSIONS This study shows the possibility of early and simple screening for patients with MCI using prosodic and acoustic features from everyday conversations with a humanoid robot with the same level of accuracy as the MMSE.
Collapse
Affiliation(s)
| | | | | | | | - Toshiro Takase
- Healthcare and Life Science, IBM Consulting, IBM Japan, Ltd, Tokyo, Japan
| | | | | | - Miyuki Nemoto
- Department of Psychiatry, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Ryohei Watanabe
- Department of Psychiatry, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Miho Ota
- Department of Psychiatry, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Shinji Higashi
- Department of Psychiatry, Ibaraki Medical Center, Tokyo Medical University, Ibaraki, Japan
| | - Kiyotaka Nemoto
- Department of Psychiatry, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Tetsuaki Arai
- Department of Psychiatry, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Masafumi Nishimura
- Department of Informatics, Graduate School of Intergraded Science and Technology, Shizuoka University, Hamamatsu, Japan
| |
Collapse
|
57
|
Zary N, Eysenbach G, Zhou X, Ma K. Impact of Gamification on Consumers' Favorability in Cause-Related Marketing Programs: Between-Subjects Experiments. JMIR Serious Games 2023; 11:e35756. [PMID: 36626196 PMCID: PMC9947917 DOI: 10.2196/35756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 10/01/2022] [Accepted: 12/01/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Successful cause-related marketing (CRM) campaigns can help companies stand out from their competitors; however, CRM may not have pleasant outcomes, even if it receives substantial investment. OBJECTIVE This research aimed to investigate how gamified CRM projects influence consumers' favorability. METHODS We introduced 3 different CRM projects in 3 different studies. Every project had 2 versions according to the level of gamification, and participants were randomly assigned into these 2 groups. Additionally, we used a 2 (gamification: lower, higher) 2 (rules presentation: without visual cues, with visual cues) between-subjects design to test the moderation role of rules presentation in gamified CRM projects. RESULTS In Study 1, we identified that the highly gamified CRM program induces more enjoyment (F1,139=21.11, P<.001) and higher favorability (F1,139=14.57, P<.001). Moreover, we found that enjoyment played a mediation role between gamification and favorability (P<.001) in Study 2. In addition, the results of Study 3 indicated rules presentation in a gamified CRM program can moderate the indirect effect of gamification on favorability via enjoyment (index of the moderated mediation: 95% CI -1.12 to -0.10; for rules presentation with visual cues: 95% CI 0.69 to 1.40; for rules presentation without visual cues: 95% CI 0.08 to 0.83). CONCLUSIONS Overall, this research contributes to the CRM literature and suggests gamification is an effective way of managing CRM campaigns.
Collapse
Affiliation(s)
| | | | - Xiu Zhou
- School of Accounting and Finance, Beijing Institute of Technology, Zhuhai, China
| | - Kunshu Ma
- School of Management, Southwest Minzu University, Chengdu, China
| |
Collapse
|
58
|
Iyer R, Meyer D. Detection of Suicide Risk Using Vocal Characteristics: Systematic Review. JMIR BIOMEDICAL ENGINEERING 2022; 7:e42386. [PMID: 38875684 PMCID: PMC11041425 DOI: 10.2196/42386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 12/01/2022] [Accepted: 12/01/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND In an age when telehealth services are increasingly being used for forward triage, there is a need for accurate suicide risk detection. Vocal characteristics analyzed using artificial intelligence are now proving capable of detecting suicide risk with accuracies superior to traditional survey-based approaches, suggesting an efficient and economical approach to ensuring ongoing patient safety. OBJECTIVE This systematic review aimed to identify which vocal characteristics perform best at differentiating between patients with an elevated risk of suicide in comparison with other cohorts and identify the methodological specifications of the systems used to derive each feature and the accuracies of classification that result. METHODS A search of MEDLINE via Ovid, Scopus, Computers and Applied Science Complete, CADTH, Web of Science, ProQuest Dissertations and Theses A&I, Australian Policy Online, and Mednar was conducted between 1995 and 2020 and updated in 2021. The inclusion criteria were human participants with no language, age, or setting restrictions applied; randomized controlled studies, observational cohort studies, and theses; studies that used some measure of vocal quality; and individuals assessed as being at high risk of suicide compared with other individuals at lower risk using a validated measure of suicide risk. Risk of bias was assessed using the Risk of Bias in Non-randomized Studies tool. A random-effects model meta-analysis was used wherever mean measures of vocal quality were reported. RESULTS The search yielded 1074 unique citations, of which 30 (2.79%) were screened via full text. A total of 21 studies involving 1734 participants met all inclusion criteria. Most studies (15/21, 71%) sourced participants via either the Vanderbilt II database of recordings (8/21, 38%) or the Silverman and Silverman perceptual study recording database (7/21, 33%). Candidate vocal characteristics that performed best at differentiating between high risk of suicide and comparison cohorts included timing patterns of speech (median accuracy 95%), power spectral density sub-bands (median accuracy 90.3%), and mel-frequency cepstral coefficients (median accuracy 80%). A random-effects meta-analysis was used to compare 22 characteristics nested within 14% (3/21) of the studies, which demonstrated significant standardized mean differences for frequencies within the first and second formants (standardized mean difference ranged between -1.07 and -2.56) and jitter values (standardized mean difference=1.47). In 43% (9/21) of the studies, risk of bias was assessed as moderate, whereas in the remaining studies (12/21, 57%), the risk of bias was assessed as high. CONCLUSIONS Although several key methodological issues prevailed among the studies reviewed, there is promise in the use of vocal characteristics to detect elevations in suicide risk, particularly in novel settings such as telehealth or conversational agents. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD420200167413; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020167413.
Collapse
Affiliation(s)
- Ravi Iyer
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, Australia
| | - Denny Meyer
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, Australia
| |
Collapse
|
59
|
Basch C, Eysenbach G, Nakayama Y, Suda T, Uno T, Hashimoto T, Toyoda M, Yoshinaga N, Kitsuregawa M, Rocha LEC. Evolution of Public Opinion on COVID-19 Vaccination in Japan: Large-Scale Twitter Data Analysis. J Med Internet Res 2022; 24:e41928. [PMID: 36343186 PMCID: PMC9856430 DOI: 10.2196/41928] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/09/2022] [Accepted: 10/24/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Vaccines are promising tools to control the spread of COVID-19. An effective vaccination campaign requires government policies and community engagement, sharing experiences for social support, and voicing concerns about vaccine safety and efficiency. The increasing use of online social platforms allows us to trace large-scale communication and infer public opinion in real time. OBJECTIVE This study aimed to identify the main themes in COVID-19 vaccine-related discussions on Twitter in Japan and track how the popularity of the tweeted themes evolved during the vaccination campaign. Furthermore, we aimed to understand the impact of critical social events on the popularity of the themes. METHODS We collected more than 100 million vaccine-related tweets written in Japanese and posted by 8 million users (approximately 6.4% of the Japanese population) from January 1 to October 31, 2021. We used Latent Dirichlet Allocation to perform automated topic modeling of tweet text during the vaccination campaign. In addition, we performed an interrupted time series regression analysis to evaluate the impact of 4 critical social events on public opinion. RESULTS We identified 15 topics grouped into the following 4 themes: (1) personal issue, (2) breaking news, (3) politics, and (4) conspiracy and humor. The evolution of the popularity of themes revealed a shift in public opinion, with initial sharing of attention over personal issues (individual aspect), collecting information from news (knowledge acquisition), and government criticism to focusing on personal issues. Our analysis showed that the Tokyo Olympic Games affected public opinion more than other critical events but not the course of vaccination. Public opinion about politics was significantly affected by various social events, positively shifting attention in the early stages of the vaccination campaign and negatively shifting attention later. CONCLUSIONS This study showed a striking shift in public interest in Japan, with users splitting their attention over various themes early in the vaccination campaign and then focusing only on personal issues, as trust in vaccines and policies increased. An interrupted time series regression analysis showed that the vaccination rollout to the general population (under 65 years) increased the popularity of tweets about practical advice and personal vaccination experience, and the Tokyo Olympic Games disrupted public opinion but not the course of the vaccination campaign. The methodology developed here allowed us to monitor the evolution of public opinion and evaluate the impact of social events on public opinion, using large-scale Twitter data.
Collapse
Affiliation(s)
| | | | - Yuri Nakayama
- Graduate School of Frontier Sciences, The University of Tokyo, Kashiwa, Japan
| | - Towa Suda
- Principles of Informatics Research Division, National Institute of Informatics, Tokyo, Japan
| | - Takeaki Uno
- Principles of Informatics Research Division, National Institute of Informatics, Tokyo, Japan
| | - Takako Hashimoto
- Faculty of Commerce and Economics, Chiba University of Commerce, Ichikawa, Japan
| | - Masashi Toyoda
- Institute of Industrial Science, The University of Tokyo, Tokyo, Japan
| | - Naoki Yoshinaga
- Institute of Industrial Science, The University of Tokyo, Tokyo, Japan
| | - Masaru Kitsuregawa
- Institute of Industrial Science, The University of Tokyo, Tokyo, Japan.,National Institute of Informatics, Tokyo, Japan
| | - Luis E C Rocha
- Department of Economics, Ghent University, Ghent, Belgium.,Department of Physics and Astronomy, Ghent University, Ghent, Belgium
| |
Collapse
|
60
|
Anderson MA, Budney AJ, Jacobson NC, Nahum-Shani I, Stanger C. End User Participation in the Development of an Ecological Momentary Intervention to Improve Coping With Cannabis Cravings: Formative Study. JMIR Form Res 2022; 6:e40139. [PMID: 36520509 PMCID: PMC9801264 DOI: 10.2196/40139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 10/28/2022] [Accepted: 11/01/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Cannabis misuse in young adults is a major public health concern. An important predictor of continued use is cannabis craving. Due to the time-varying nature of cravings, brief momentary interventions delivered while cravings are elevated may improve the use of strategies to cope with cravings and reduce cannabis use. OBJECTIVE The goal of this manuscript is to describe a formative study to develop coping strategy messages for use in a subsequent intervention. METHODS Young adults (aged 19-25 years; n=20) who reported using cannabis >10 of the past 30 days recruited via social media participated in this formative study. Participants rated an initial set of 15 mindfulness and 15 distraction coping strategies on a scale from 1 to 4 (very low degree to very high degree) for clarity, usefulness, and tone. They also provided comments about the content. RESULTS Participants found the initial distraction messages slightly clearer than mindfulness (mean 3.5, SD 0.4 and mean 3.4, SD 0.4, respectively), both were comparable in tone (mean 3.2, SD 0.5 and mean 3.2, SD 0.4, respectively), and mindfulness messages were more useful than distraction (mean 3.0, SD 0.5 and mean 2.8, SD 0.6, respectively). Of the 30 messages, 29 received a rating of very low or low (<2) on any domain by >3 participants or received a comment suggesting a change. We revised all these messages based on this feedback, and the participants rated the revised messages approximately 2 weeks later. Participants earned US $10 for completing the first and US $20 for the second survey. The ratings improved on usefulness (especially the distraction items) with very little change in clarity and tone. The top 10 messages of each coping type (mindfulness and distraction) were identified by overall average rating (collapsed across all 3 dimensions: all rated >3.0). The final items were comparable in clarity (distraction mean 3.6, SD 0.4; mindfulness mean 3.6, SD 0.4), tone (distraction mean 3.4, SD 0.4; mindfulness mean 3.4, SD 0.4), and usefulness (distraction mean 3.1, SD 0.5; mindfulness mean 3.2, SD 0.5). CONCLUSIONS The inclusion of end users in the formative process of developing these messages was valuable and resulted in improvements to the content of the messages. The majority of the messages were changed in some way including the removal of potentially triggering language. These messages were subsequently used in an ecological momentary intervention.
Collapse
Affiliation(s)
- Molly A Anderson
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States
| | - Alan J Budney
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States
| | - Nicholas C Jacobson
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States
| | - Inbal Nahum-Shani
- Institute for Social Research, University of Michigan, Ann Arbor, MI, United States
| | - Catherine Stanger
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States
| |
Collapse
|
61
|
Hernández-Rodríguez JC, García-Muñoz C, Ortiz-Álvarez J, Saigí-Rubió F, Conejo-Mir J, Pereyra-Rodriguez JJ. Dropout Rate in Digital Health Interventions for the Prevention of Skin Cancer: Systematic Review, Meta-analysis, and Metaregression. J Med Internet Res 2022; 24:e42397. [PMID: 36485027 PMCID: PMC9789500 DOI: 10.2196/42397] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 11/10/2022] [Accepted: 11/28/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Digital strategies are innovative approaches to the prevention of skin cancer, but the attrition following this kind of intervention needs to be analyzed. OBJECTIVE The aim of this paper is to assess the dropouts from studies focused on digital strategies for the prevention of skin cancer. METHODS We conducted this systematic review with meta-analyses and metaregression according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statements. Search terms for skin cancer, digital strategies, and prevention were combined to search PubMed, Scopus, Web of Science, CINAHL, and Cochrane Library from inception until July 2022. Randomized clinical trials that reported dropouts of participants and compared digital strategies with other interventions to prevent skin cancer in healthy or disease-free participants were included. Two independent reviewers extracted data for analysis. The Revised Cochrane Collaboration Bias tool was employed. We calculated the pooled dropout rate of participants through a meta-analysis of proportions and examined whether dropout was more or less frequent in digital interventions against comparators via an odds ratio (OR) meta-analysis. Data were pooled using a random-effects model. Subgroup meta-analyses were conducted in a meta-analysis of proportions and OR meta-analysis to assess the dropout events when data were sorted by digital interventions or control comparator. A univariate metaregression based on a random-effects model assessed possible moderators of dropout. Participants' dropout rates as pooled proportions were calculated for all groups combined, and the digital and comparator groups separately. OR>1 indicated higher dropouts for digital-based interventions. Metaregressions were performed for age, sex, length of intervention, and sample size. RESULTS A total of 17 studies were included. The overall pooled dropout rate was 9.5% (95% CI 5.0-17.5). The subgroup meta-analysis of proportions revealed a dropout rate of 11.6% for digital strategies (95% CI 6.8-19.0) and 10.0% for comparators (95% CI 5.5-17.7). A trend of higher dropout rates for digital strategies was observed in the overall (OR 1.16, 95% CI 0.98-1.36) and subgroup OR meta-analysis, but no significant differences were found between the groups. None of the covariates moderated the effect size in the univariate metaregression. CONCLUSIONS Digital strategies had a higher dropout rate compared to other prevention interventions, but the difference was not significant. Standardization is needed regarding reporting the number of and reasons for dropouts. TRIAL REGISTRATION International Prospective Register of Systematic Reviews (PROSPERO) CRD42022329669; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=329669.
Collapse
Affiliation(s)
| | | | - Juan Ortiz-Álvarez
- Department of Dermatology, Virgen del Rocío University Hospital, Seville, Spain
| | | | - Julián Conejo-Mir
- Department of Dermatology, Virgen del Rocío University Hospital, Seville, Spain
- Department of Medicine, University of Seville, Seville, Spain
| | - Jose-Juan Pereyra-Rodriguez
- Department of Dermatology, Virgen del Rocío University Hospital, Seville, Spain
- Department of Medicine, University of Seville, Seville, Spain
| |
Collapse
|
62
|
Mayer G, Gronewold N, Polte K, Hummel S, Barniske J, Korbel JJ, Zarnekow R, Schultz JH. Experiences of Patients and Therapists Testing a Virtual Reality Exposure App for Symptoms of Claustrophobia: Mixed Methods Study. JMIR Ment Health 2022; 9:e40056. [PMID: 36469413 PMCID: PMC9764154 DOI: 10.2196/40056] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 08/20/2022] [Accepted: 10/17/2022] [Indexed: 11/07/2022] Open
Abstract
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.
Collapse
Affiliation(s)
- Gwendolyn Mayer
- Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Nadine Gronewold
- Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Kirsten Polte
- Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Svenja Hummel
- Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Joshua Barniske
- Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Jakob J Korbel
- Information and Communication Management, Technische Universität Berlin, Berlin, Germany
| | - Rüdiger Zarnekow
- Information and Communication Management, Technische Universität Berlin, Berlin, Germany
| | - Jobst-Hendrik Schultz
- Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany
| |
Collapse
|
63
|
Shah P, Raymond JK, Espinoza J. Modified e-Delphi Process for the Selection of Patient-Reported Outcome Measures for Children and Families With Type 1 Diabetes Using Continuous Glucose Monitors: Delphi Study. JMIR Diabetes 2022; 7:e38660. [PMID: 36265838 PMCID: PMC9752458 DOI: 10.2196/38660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 09/23/2022] [Accepted: 10/15/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Type 1 diabetes (T1D) management is complex and associated with significant psychosocial burden. Continuous glucose monitors (CGM) can improve disease management and outcomes and introduce new or exacerbate existing psychosocial concerns. Patient-reported outcome measures (PROMs) can be used to capture this information, but there is no consensus on which PROMs should be used in pediatric CGM research. OBJECTIVE Here we describe the process to (1) identify PROMs that could be used to assess the impact of CGMs on pediatric patients with T1D, (2) implement a modified electronic Delphi (e-Delphi) methodology to arrive at an expert consensus on which PROMs are most suitable for clinical and research applications, and (3) establish a periodicity table for the administration of PROMs over time in a real-world evidence study. METHODS To identify appropriate PROMs for pediatric patients and families with T1D and CGMs, we conducted an asynchronous, e-Delphi process with a multidisciplinary group of experts from around the country. We identified candidate instruments through a literature review. The 3-round e-Delphi process was conducted via a study website, email, and web-based forms. Participants provided opinions on the usefulness of instruments, age validation, feasibility, time, and frequency of administration. RESULTS In total, 16 experts participated in the e-Delphi process; 4 of whom consistently participated in all 3 rounds. We identified 62 candidate instruments, which were narrowed down to 12 final PROMs across 5 domains: diabetes distress and burden (n=4), autonomy (n=2), quality of life (n=1), psychosocial (n=3), and technology acceptance (n=2). A quarterly administration schedule was developed to reduce burden on participants. CONCLUSIONS PROMs can provide critical insights into the psychosocial well-being of patients. The specific measures identified in the paper are particularly well suited for pediatric patients with T1D using CGMs. Clinical implementation could help health care providers, patients, and families to engage in more comprehensive disease management.
Collapse
Affiliation(s)
- Payal Shah
- Children's Hospital Los Angeles, Los Angeles, CA, United States
| | | | - Juan Espinoza
- Children's Hospital Los Angeles, Los Angeles, CA, United States
| |
Collapse
|
64
|
Alopoudi A, Makri M, Alişoğlu B, DOĞAN A, Imbesi A, Karakoyun M, Lacapelle A, Navvaro Roux MA, Pissa A, Tsolaki M. Non pharmacological intervention for the improvement of cognitive skills of adults with Intellectual Disabilities (Mild and Moderate Intellectual Disability, Mild Cognitive Impairment, Autism Spectrum Disorder, Down Syndrome): mixed method study protocol for Game4CoSkills project (Preprint). JMIR Res Protoc 2022. [DOI: 10.2196/44386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
|
65
|
Abdallah L, Stolee P, Lopez KJ, Whate A, Boger J, Tong C. The Impact of COVID-19 on Older Adults' Perceptions of Virtual Care: Qualitative Study. JMIR Aging 2022; 5:e38546. [PMID: 36054599 PMCID: PMC9586256 DOI: 10.2196/38546] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 08/22/2022] [Accepted: 08/30/2022] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND In response to the COVID-19 pandemic, older adults worldwide have increasingly received health care virtually, and health care organizations and professional bodies have indicated that virtual care is "here to stay." As older adults are the highest users of the health care system, virtual care implementation can have a significant impact on them and may pose a need for additional support. OBJECTIVE This research aims to understand older adults' perspectives and experiences of virtual care during the pandemic. METHODS As part of a larger study on older adults' technology use during the pandemic, we conducted semistructured interviews with 20 diverse older Canadians (mean age 76.9 years, SD 6.5) at 2 points: summer of 2020 and winter/early spring of 2021. Participants were asked about their technology skills, experiences with virtual appointments, and perspectives on this type of care delivery. Interviews were digitally recorded and transcribed. A combination of team-based and framework analyses was used to interpret the data. RESULTS Participants described their experiences with both in-person and virtual care during the pandemic, including issues with accessing care and long gaps between appointments. Overall, participants were generally satisfied with the virtual care they received during the pandemic. Participants described the benefits of virtual care (eg, increased convenience, efficiency, and safety), the limitations of virtual care (eg, need for physical examination and touch, lack of nonverbal communication, difficulties using technology, and systemic barriers in access), and their perspectives on the future of virtual care. Half of our participants preferred a return to in-person care after the COVID-19 pandemic, while the other half preferred a combination of in-person and virtual services. Many participants who preferred to access in-person services were not opposed to virtual care options, as needed; however, they wanted virtual care as an option alongside in-person care. Participants emphasized a need for training and support to be meaningfully implemented to support both older adults and providers in using virtual care. CONCLUSIONS Overall, our research identified both perceived benefits and perceived limitations of virtual care, and older adult participants emphasized their wish for a hybrid model of virtual care, in which virtual care is viewed as an addendum, not a replacement for in-person care. We recognize the limitations of our sample (small, not representative of all older Canadians, and more likely to use technology); this body of literature would greatly benefit from more research with older adults who do not/cannot use technology to receive care. Findings from this study can be mobilized as part of broader efforts to support older patients and providers engaged in virtual and in-person care, particularly post-COVID-19.
Collapse
Affiliation(s)
- Lama Abdallah
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Paul Stolee
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Kimberly J Lopez
- Department of Recreation and Leisure, University of Waterloo, Waterloo, ON, Canada
| | - Alexandra Whate
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Jennifer Boger
- Department of Systems Design Engineering, University of Waterloo, Waterloo, ON, Canada
| | - Catherine Tong
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| |
Collapse
|
66
|
de Buisonjé DR, Reijnders T, Cohen Rodrigues TR, Prabhakaran S, Kowatsch T, Lipman SA, Bijmolt THA, Breeman LD, Janssen VR, Kraaijenhagen RA, Kemps HMC, Evers AWM. Investigating Rewards and Deposit Contract Financial Incentives for Physical Activity Behavior Change Using a Smartphone App: Randomized Controlled Trial. J Med Internet Res 2022; 24:e38339. [PMID: 36201384 DOI: 10.2196/38339] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 08/04/2022] [Accepted: 08/11/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Financial incentive interventions for improving physical activity have proven to be effective but costly. Deposit contracts (in which participants pledge their own money) could be an affordable alternative. In addition, deposit contracts may have superior effects by exploiting the power of loss aversion. Previous research has often operationalized deposit contracts through loss framing a financial reward (without requiring a deposit) to mimic the feelings of loss involved in a deposit contract. OBJECTIVE This study aimed to disentangle the effects of incurring actual losses (through self-funding a deposit contract) and loss framing. We investigated whether incentive conditions are more effective than a no-incentive control condition, whether deposit contracts have a lower uptake than financial rewards, whether deposit contracts are more effective than financial rewards, and whether loss frames are more effective than gain frames. METHODS Healthy participants (N=126) with an average age of 22.7 (SD 2.84) years participated in a 20-day physical activity intervention. They downloaded a smartphone app that provided them with a personalized physical activity goal and either required a €10 (at the time of writing: €1=US $0.98) deposit up front (which could be lost) or provided €10 as a reward, contingent on performance. Daily feedback on incentive earnings was provided and framed as either a loss or gain. We used a 2 (incentive type: deposit or reward) × 2 (feedback frame: gain or loss) between-subjects factorial design with a no-incentive control condition. Our primary outcome was the number of days participants achieved their goals. The uptake of the intervention was a secondary outcome. RESULTS Overall, financial incentive conditions (mean 13.10, SD 6.33 days goal achieved) had higher effectiveness than the control condition (mean 8.00, SD 5.65 days goal achieved; P=.002; ηp2=0.147). Deposit contracts had lower uptake (29/47, 62%) than rewards (50/50, 100%; P<.001; Cramer V=0.492). Furthermore, 2-way analysis of covariance showed that deposit contracts (mean 14.88, SD 6.40 days goal achieved) were not significantly more effective than rewards (mean 12.13, SD 6.17 days goal achieved; P=.17). Unexpectedly, loss frames (mean 10.50, SD 6.22 days goal achieved) were significantly less effective than gain frames (mean 14.67, SD 5.95 days goal achieved; P=.007; ηp2=0.155). CONCLUSIONS Financial incentives help increase physical activity, but deposit contracts were not more effective than rewards. Although self-funded deposit contracts can be offered at low cost, low uptake is an important obstacle to large-scale implementation. Unexpectedly, loss framing was less effective than gain framing. Therefore, we urge further research on their boundary conditions before using loss-framed incentives in practice. Because of limited statistical power regarding some research questions, the results of this study should be interpreted with caution, and future work should be done to confirm these findings. TRIAL REGISTRATION Open Science Framework Registries osf.io/34ygt; https://osf.io/34ygt.
Collapse
Affiliation(s)
- David R de Buisonjé
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, Netherlands
| | - Thomas Reijnders
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, Netherlands
- Department of Human-Centered Design, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - Talia R Cohen Rodrigues
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, Netherlands
| | - Santhanam Prabhakaran
- Centre for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
| | - Tobias Kowatsch
- Centre for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
- Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland
- School of Medicine, University of St. Gallen, St. Gallen, Switzerland
| | - Stefan A Lipman
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Tammo H A Bijmolt
- Faculty of Economics and Business, University of Groningen, Groningen, Netherlands
| | - Linda D Breeman
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, Netherlands
| | - Veronica R Janssen
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, Netherlands
- Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands
| | | | - Hareld M C Kemps
- Department of Cardiology, Máxima Medical Center, Veldhoven, Netherlands
| | - Andrea W M Evers
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, Netherlands
- Medical Delta, Leiden University, Technical University Delft, Erasmus University, Delft, Netherlands
| |
Collapse
|
67
|
You Y, Yang-Huang J, Raat H, Van Grieken A. Social Media Use and Health-Related Quality of Life Among Adolescents: Cross-sectional Study. JMIR Ment Health 2022; 9:e39710. [PMID: 36194460 PMCID: PMC9579926 DOI: 10.2196/39710] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 07/25/2022] [Accepted: 08/04/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Using social media is a time-consuming activity of children and adolescents. Health authorities have warned that excessive use of social media can negatively affect adolescent social, physical, and psychological health. However, scientific findings regarding associations between time spent on social media and adolescent health-related quality of life (HRQoL) are not consistent. Adolescents typically use multiple social media platforms. Whether the use of multiple social media platforms impacts adolescent health is unclear. OBJECTIVE The aim of this study was to examine the relationship between social media use, including the number of social media platforms used and time spent on social media, and adolescent HRQoL. METHODS We analyzed the data of 3397 children (mean age 13.5, SD 0.4 years) from the Generation R Study, a population-based cohort study in the Netherlands. Children reported the number of social media platforms used and time spent on social media during weekdays and weekends separately. Children's HRQoL was self-reported with the EuroQol 5-dimension questionnaire-youth version. Data on social media use and HRQoL were collected from 2015 to 2019. Multiple logistic and linear regressions were applied. RESULTS In this study, 72.6% (2466/3397) of the children used 3 or more social media platforms, and 37.7% (1234/3276) and 58.3% (1911/3277) of the children used social media at least 2 hours per day during weekdays and weekends, respectively. Children using more social media platforms (7 or more platforms) had a higher odds of reporting having some or a lot of problems on "having pain or discomfort" (OR 1.55, 95% CI 1.20 to 1.99) and "feeling worried, sad or unhappy" (OR 1.99, 95% CI 1.52 to 2.60) dimensions and reported lower self-rated health (β -3.81, 95% CI -5.54 to -2.09) compared with children who used 0 to 2 social media platforms. Both on weekdays and weekends, children spent more time on social media were more likely to report having some or a lot of problems on "doing usual activities," "having pain or discomfort," "feeling worried, sad or unhappy," and report lower self-rated health (all P<.001). CONCLUSIONS Our findings indicate that using more social media platforms and spending more time on social media were significantly related to lower HRQoL. We recommend future research to study the pathway between social media use and HRQoL among adolescents.
Collapse
Affiliation(s)
- Yueyue You
- The Generation R Study Group, Erasmus Medical Center, Rotterdam, Netherlands.,Department of Public Health, Erasmus Medical Center, Rotterdam, Netherlands
| | - Junwen Yang-Huang
- The Generation R Study Group, Erasmus Medical Center, Rotterdam, Netherlands.,Department of Public Health, Erasmus Medical Center, Rotterdam, Netherlands
| | - Hein Raat
- Department of Public Health, Erasmus Medical Center, Rotterdam, Netherlands
| | - Amy Van Grieken
- Department of Public Health, Erasmus Medical Center, Rotterdam, Netherlands
| |
Collapse
|
68
|
Shah RR, Bailey JP. Asymmetric Interoperability: Directional Analysis of Provider Group Health Information Exchange (Preprint). J Med Internet Res 2022; 25:e43127. [PMID: 37023418 PMCID: PMC10131629 DOI: 10.2196/43127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 01/30/2023] [Accepted: 02/13/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND High levels of seamless, bidirectional health information exchange continue to be broadly limited among provider groups despite the vast array of benefits that interoperability entails for patient care and the many persistent efforts across the health care ecosystem directed at advancing interoperability. As provider groups seek to act in their strategic best interests, they are often interoperable and exchange information in certain directions but not others, leading to the formation of asymmetries. OBJECTIVE We aimed to examine the correlation at the provider group level between the distinct directions of interoperability with regard to sending health information and receiving health information, to describe how this correlation varies across provider group types and provider group sizes, and to analyze the symmetries and asymmetries that arise in the exchange of patient health information across the health care ecosystem as a result. METHODS We used data from the Centers for Medicare & Medicaid Services (CMS), which included interoperability performance information for 2033 provider groups within the Quality Payment Program Merit-based Incentive Payment System and maintained distinct performance measures for sending health information and receiving health information. In addition to compiling descriptive statistics, we also conducted a cluster analysis to identify differences among provider groups-particularly with respect to symmetric versus asymmetric interoperability. RESULTS We found that the examined directions of interoperability-sending health information and receiving health information-have relatively low bivariate correlation (0.4147) with a significant number of observations exhibiting asymmetric interoperability (42.5%). Primary care providers are generally more likely to exchange information asymmetrically than specialty providers, being more inclined to receive health information than to send health information. Finally, we found that larger provider groups are significantly less likely to be bidirectionally interoperable than smaller groups, although both are asymmetrically interoperable at similar rates. CONCLUSIONS The adoption of interoperability by provider groups is more nuanced than traditionally considered and should not be seen as a binary determination (ie, to be interoperable or not). Asymmetric interoperability-and its pervasive presence among provider groups-reiterates how the manner in which provider groups exchange patient health information is a strategic choice and may pose similar implications and potential harms as the practice of information blocking has in the past. Differences in the operational paradigms among provider groups of varying types and sizes may explain their varying extents of health information exchange for sending and receiving health information. There continues to remain substantial room for improvement on the path to achieving a fully interoperable health care ecosystem, and future policy efforts directed at advancing interoperability should consider the practice of being asymmetrically interoperable among provider groups.
Collapse
Affiliation(s)
- Rohin Rathin Shah
- The Robert H. Smith School of Business, University of Maryland, College Park, MD, United States
- Poolesville High School, Poolesville, MD, United States
| | - Joseph Peter Bailey
- The Robert H. Smith School of Business, University of Maryland, College Park, MD, United States
| |
Collapse
|
69
|
Schucht P, Mathis AM, Murek M, Zubak I, Goldberg J, Falk S, Raabe A. Exploring Novel Innovation Strategies to Close a Technology Gap in Neurosurgery: The HORAO Crowdsourcing Campaign (Preprint). J Med Internet Res 2022; 25:e42723. [PMID: 37115612 PMCID: PMC10182462 DOI: 10.2196/42723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 02/14/2023] [Accepted: 03/12/2023] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND Scientific research is typically performed by expert individuals or groups who investigate potential solutions in a sequential manner. Given the current worldwide exponential increase in technical innovations, potential solutions for any new problem might already exist, even though they were developed to solve a different problem. Therefore, in crowdsourcing ideation, a research question is explained to a much larger group of individuals beyond the specialist community to obtain a multitude of diverse, outside-the-box solutions. These are then assessed in parallel by a group of experts for their capacity to solve the new problem. The 2 key problems in brain tumor surgery are the difficulty of discerning the exact border between a tumor and the surrounding brain, and the difficulty of identifying the function of a specific area of the brain. Both problems could be solved by a method that visualizes the highly organized fiber tracts within the brain; the absence of fibers would reveal the tumor, whereas the spatial orientation of the tracts would reveal the area's function. To raise awareness about our challenge of developing a means of intraoperative, real-time, noninvasive identification of fiber tracts and tumor borders to improve neurosurgical oncology, we turned to the crowd with a crowdsourcing ideation challenge. OBJECTIVE Our objective was to evaluate the feasibility of a crowdsourcing ideation campaign for finding novel solutions to challenges in neuroscience. The purpose of this paper is to introduce our chosen crowdsourcing method and discuss it in the context of the current literature. METHODS We ran a prize-based crowdsourcing ideation competition called HORAO on the commercial platform HeroX. Prize money previously collected through a crowdfunding campaign was offered as an incentive. Using a multistage approach, an expert jury first selected promising technical solutions based on broad, predefined criteria, coached the respective solvers in the second stage, and finally selected the winners in a conference setting. We performed a postchallenge web-based survey among the solvers crowd to find out about their backgrounds and demographics. RESULTS Our web-based campaign reached more than 20,000 people (views). We received 45 proposals from 32 individuals and 7 teams, working in 26 countries on 4 continents. The postchallenge survey revealed that most of the submissions came from single solvers or teams working in engineering or the natural sciences, with additional submissions from other nonmedical fields. We engaged in further exchanges with 3 out of the 5 finalists and finally initiated a successful scientific collaboration with the winner of the challenge. CONCLUSIONS This open innovation competition is the first of its kind in medical technology research. A prize-based crowdsourcing ideation campaign is a promising strategy for raising awareness about a specific problem, finding innovative solutions, and establishing new scientific collaborations beyond strictly disciplinary domains.
Collapse
Affiliation(s)
- Philippe Schucht
- Department of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Andrea Maria Mathis
- Department of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Michael Murek
- Department of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Irena Zubak
- Department of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Johannes Goldberg
- Department of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Stephanie Falk
- Department of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Andreas Raabe
- Department of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| |
Collapse
|
70
|
Xie LF, Housni A, Nakhla M, Cianci R, Leroux C, Da Costa D, Brazeau AS. Adaptation of an adult web application for type 1 diabetes self-management to youth: use of the Behaviour Change Wheel to tailor the needs of healthcare transition- A qualitative study (Preprint). JMIR Diabetes 2022; 8:e42564. [PMID: 37121571 PMCID: PMC10173038 DOI: 10.2196/42564] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 11/24/2022] [Accepted: 01/23/2023] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Youth (aged 14-24 years) living with type 1 diabetes (T1D) encounter increased challenges in their diabetes self-management (DSM), especially during the transition to adult care. Although DSM education and support are imperative, there is insufficient information on how web-based digital tools tailored to their demands can be developed. OBJECTIVE On the basis of the Behavior Change Wheel, this study aims to identify, among youth living with T1D, the needs and factors influencing their DSM in the context of health care transition and to inform the adaptation (content and features) of an adult self-guided web application (Support). METHODS Internet-based semistructured individual interviews based on a phenomenological study design were conducted with 21 youths, and transcripts were analyzed using an inductive approach with concept mapping. RESULTS Factors influencing T1D self-management were categorized into barriers and facilitators and then as external or internal. Features influencing the accessibility to information, increasing the sense of support, and use of the tool were positively accepted. Features unrelated to their expectations of digital tool use or difficulty navigating were viewed negatively. Participants expressed an interest in reliable, practical, and novel educational content. Although youth considered the information provided by medical professionals to be important, peer exchange was deemed necessary to obtain a practical perspective and real-life examples. CONCLUSIONS Compared with the adult population, in addition to tailored content and a simplified information search process, when building a DSM education and support digital tool for youth, features should be selected to encourage supervised peer exchange.
Collapse
Affiliation(s)
- Li Feng Xie
- School of Human Nutrition, McGill University, Sainte-Anne-de-Bellevue, QC, Canada
| | - Asmaa Housni
- School of Human Nutrition, McGill University, Sainte-Anne-de-Bellevue, QC, Canada
| | - Meranda Nakhla
- The Research Institute of the McGill University Health Centre, Montreal, QC, Canada
- Division of Endocrinology, Montreal Children's Hospital, Montreal, QC, Canada
| | - Rosemarie Cianci
- School of Human Nutrition, McGill University, Sainte-Anne-de-Bellevue, QC, Canada
| | - Catherine Leroux
- School of Human Nutrition, McGill University, Sainte-Anne-de-Bellevue, QC, Canada
| | - Deborah Da Costa
- The Research Institute of the McGill University Health Centre, Montreal, QC, Canada
- Department of Medicine, McGill University, Montreal, QC, Canada
| | - Anne-Sophie Brazeau
- School of Human Nutrition, McGill University, Sainte-Anne-de-Bellevue, QC, Canada
- Montreal Diabetes Research Center, Montreal, QC, Canada
| |
Collapse
|
71
|
Langener S, Kolkmeier J, VanDerNagel J, Klaassen R, van Manen J, Heylen D. Development of an alcohol refusal training in Immersive Virtual Reality for patients with Mild to Borderline Intellectual Disability and Alcohol Use Disorder: Co-creation with experts in addiction care. (Preprint). JMIR Form Res 2022; 7:e42523. [PMID: 37099362 PMCID: PMC10173034 DOI: 10.2196/42523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 03/12/2023] [Accepted: 03/16/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND People with mild to borderline intellectual disability (MBID; IQ=50-85) are at risk for developing an alcohol use disorder (AUD). One factor contributing to this risk is sensitivity to peer pressure. Hence, tailored trainings are needed to practice alcohol refusal in impacted patients. Immersive virtual reality (IVR) appears promising to engage patients in dialogs with virtual humans, allowing to practice alcohol refusal realistically. However, requirements for such an IVR have not been studied for MBID/AUD. OBJECTIVE This study aims to develop an IVR alcohol refusal training for patients with MBID and AUD. In this work, we cocreated our peer pressure simulation with experienced experts in addiction care. METHODS We followed the Persuasive System Design (PSD) model to develop our IVR alcohol refusal training. With 5 experts from a Dutch addiction clinic for patients with MBID, we held 3 focus groups to design the virtual environment, persuasive virtual human(s), and persuasive dialog. Subsequently, we developed our initial IVR prototype and conducted another focus group to evaluate IVR and procedures for clinical usage, resulting in our final peer pressure simulation. RESULTS Our experts described visiting a friend at home with multiple friends as the most relevant peer pressure situation in the clinical setting. Based on the identified requirements, we developed a social-housing apartment with multiple virtual friends present. Moreover, we embedded a virtual man with generic appearance to exert peer pressure using a persuasive dialog. Patients can respond to persuasive attempts by selecting (refusal) responses with varying degrees of risk for relapse in alcohol use. Our evaluation showed that experts value a realistic and interactable IVR. However, experts identified lacking persuasive design elements, such as paralanguage, for our virtual human. For clinical usage, a user-centered customization is needed to prevent adverse effects. Further, interventions should be therapist delivered to avoid try-and-error in patients with MBID. Lastly, we identified factors for immersion, as well as facilitators and barriers for IVR accessibility. CONCLUSIONS Our work establishes an initial PSD for IVR for alcohol refusal trainings in patients with MBID and AUD. With this, scholars can create comparable simulations by performing an analogous cocreation, replicate findings, and identify active PSD elements. For peer pressure, conveying emotional information in a virtual human's voice (eg, paralanguage) seems vital. However, previous rapport building may be needed to ensure that virtual humans are perceived as cognitively capable entities. Future work should validate our PSD with patients and start developing IVR treatment protocols using interdisciplinary teams.
Collapse
Affiliation(s)
- Simon Langener
- Department of Human Media Interaction, University of Twente, Enschede, Netherlands
- Centre for Addiction and Intellectual Disability, Tactus Addiction Care, Enschede, Netherlands
- Nijmegen Institute for Scientist-Practitioners in Addiction, Radboud University, Nijmegen, Netherlands
| | - Jan Kolkmeier
- Department of Human Media Interaction, University of Twente, Enschede, Netherlands
| | - Joanne VanDerNagel
- Department of Human Media Interaction, University of Twente, Enschede, Netherlands
- Centre for Addiction and Intellectual Disability, Tactus Addiction Care, Enschede, Netherlands
- Nijmegen Institute for Scientist-Practitioners in Addiction, Radboud University, Nijmegen, Netherlands
| | - Randy Klaassen
- Department of Human Media Interaction, University of Twente, Enschede, Netherlands
| | - Jeannette van Manen
- Centre for Addiction and Intellectual Disability, Tactus Addiction Care, Enschede, Netherlands
- Nijmegen Institute for Scientist-Practitioners in Addiction, Radboud University, Nijmegen, Netherlands
| | - Dirk Heylen
- Department of Human Media Interaction, University of Twente, Enschede, Netherlands
| |
Collapse
|
72
|
Singh L, Gresenz CR, Wang Y, Hu S. Assessing Social Media Data as a Resource for Firearm Research: Analysis of Tweets Pertaining to Firearm Deaths. J Med Internet Res 2022; 24:e38319. [PMID: 36006693 PMCID: PMC9459834 DOI: 10.2196/38319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 06/28/2022] [Accepted: 07/15/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Historic constraints on research dollars and reliable information have limited firearm research. At the same time, interest in the power and potential of social media analytics, particularly in health contexts, has surged. OBJECTIVE The aim of this study is to contribute toward the goal of establishing a foundation for how social media data may best be used, alone or in conjunction with other data resources, to improve the information base for firearm research. METHODS We examined the value of social media data for estimating a firearm outcome for which robust benchmark data exist-specifically, firearm mortality, which is captured in the National Vital Statistics System (NVSS). We hand curated tweet data from the Twitter application programming interface spanning January 1, 2017, to December 31, 2018. We developed machine learning classifiers to identify tweets that pertain to firearm deaths and develop estimates of the volume of Twitter firearm discussion by month. We compared within-state variation over time in the volume of tweets pertaining to firearm deaths with within-state trends in NVSS-based estimates of firearm fatalities using Pearson linear correlations. RESULTS The correlation between the monthly number of firearm fatalities measured by the NVSS and the monthly volume of tweets pertaining to firearm deaths was weak (median 0.081) and highly dispersed across states (range -0.31 to 0.535). The median correlation between month-to-month changes in firearm fatalities in the NVSS and firearm deaths discussed in tweets was moderate (median 0.30) and exhibited less dispersion among states (range -0.06 to 0.69). CONCLUSIONS Our findings suggest that Twitter data may hold value for tracking dynamics in firearm-related outcomes, particularly for relatively populous cities that are identifiable through location mentions in tweet content. The data are likely to be particularly valuable for understanding firearm outcomes not currently measured, not measured well, or not measurable through other available means. This research provides an important building block for future work that continues to develop the usefulness of social media data for firearm research.
Collapse
Affiliation(s)
- Lisa Singh
- Department of Computer Science, Massive Data Institute, Georgetown University, Washington, DC, United States
| | - Carole Roan Gresenz
- McCourt School of Public Policy, School of Health, Georgetown University, Washington, DC, United States
| | - Yanchen Wang
- Department of Computer Science, Georgetown University, Washington, DC, United States
| | - Sonya Hu
- Department of Computer Science, Georgetown University, Washington, DC, United States
| |
Collapse
|
73
|
Mazur LM, Khasawneh A, Fenison C, Buchanan S, Kratzke IM, Adapa K, An SJ, Butler L, Zebrowski A, Chakravarthula P, Ra JH. A Novel Theory-Based Virtual Reality Training to Improve Patient Safety Culture in the Department of Surgery of a Large Academic Medical Center: Protocol for a Mixed Methods Study. JMIR Res Protoc 2022; 11:e40445. [PMID: 36001370 PMCID: PMC9453584 DOI: 10.2196/40445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/08/2022] [Accepted: 07/12/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Preventable surgical errors of varying degrees of physical, emotional, and financial harm account for a significant number of adverse events. These errors are frequently tied to systemic problems within a health care system, including the absence of necessary policies/procedures, obstructive cultural hierarchy, and communication breakdown between staff. We developed an innovative, theory-based virtual reality (VR) training to promote understanding and sensemaking toward the holistic view of the culture of patient safety and high reliability. OBJECTIVE We aim to assess the effect of VR training on health care workers' (HCWs') understanding of contributing factors to patient safety events, sensemaking of patient safety culture, and high reliability organization principles in the laboratory environment. Further, we aim to assess the effect of VR training on patient safety culture, TeamSTEPPS behavior scores, and reporting of patient safety events in the surgery department of an academic medical center in the clinical environment. METHODS This mixed methods study uses a pre-VR versus post-VR training study design involving attending faculty, residents, nurses, technicians of the department of surgery, and frontline HCWs in the operation rooms at an academic medical center. HCWs' understanding of contributing factors to patient safety events will be assessed using a scale based on the Human Factors Analysis and Classification System. We will use the data frame theory framework, supported by a semistructured interview guide to capture the sensemaking process of patient safety culture and principles of high reliability organizations. Changes in the culture of patient safety will be quantified using the Agency for Healthcare Research and Quality surveys on patient safety culture. TeamSTEPPS behavior scores based on observation will be measured using the Teamwork Evaluation of Non-Technical Skills tool. Patient safety events reported in the voluntary institutional reporting system will be compared before the training versus those after the training. We will compare the Agency for Healthcare Research and Quality patient safety culture scores and patient safety events reporting before the training versus those after the training by using descriptive statistics and a within-subject 2-tailed, 2-sample t test with the significance level set at .05. RESULTS Ethics approval was obtained in May 2021 from the institutional review board of the University of North Carolina at Chapel Hill (22-1150). The enrollment of participants for this study will start in fall 2022 and is expected to be completed by early spring 2023. The data analysis is expected to be completed by July 2023. CONCLUSIONS Our findings will help assess the effectiveness of VR training in improving HCWs' understanding of contributing factors of patient safety events, sensemaking of patient safety culture, and principles and behaviors of high reliability organizations. These findings will contribute to developing VR training to improve patient safety culture in other specialties.
Collapse
Affiliation(s)
- Lukasz M Mazur
- Division of Healthcare Engineering, Department of Radiation Oncology, School of Medicine, University of North Carolina, Chapel Hill, NC, United States
| | - Amro Khasawneh
- Industrial Engineering Department, School of Engineering, Mercer University, Macon, GA, United States
| | - Christi Fenison
- Academic Technology Services, School of Medicine, University of North Carolina, Chapel Hill, NC, United States
| | - Shawna Buchanan
- Academic Technology Services, School of Medicine, University of North Carolina, Chapel Hill, NC, United States
| | - Ian M Kratzke
- Department of Surgery, School of Medicine, University of North Carolina, Chapel Hill, NC, United States
| | - Karthik Adapa
- Division of Healthcare Engineering, Department of Radiation Oncology, School of Medicine, University of North Carolina, Chapel Hill, NC, United States
| | - Selena J An
- Department of Surgery, School of Medicine, University of North Carolina, Chapel Hill, NC, United States
| | - Logan Butler
- Division of Healthcare Engineering, Department of Radiation Oncology, School of Medicine, University of North Carolina, Chapel Hill, NC, United States
| | - Ashlyn Zebrowski
- Division of Healthcare Engineering, Department of Radiation Oncology, School of Medicine, University of North Carolina, Chapel Hill, NC, United States
| | - Praneeth Chakravarthula
- Department of Computer Science, University of North Carolina, Chapel Hill, NC, United States
| | - Jin H Ra
- Department of Surgery, School of Medicine, University of North Carolina, Chapel Hill, NC, United States
| |
Collapse
|
74
|
Li SH, Achilles MR, Werner-Seidler A, Beames JR, Subotic-Kerry M, O'Dea B. Appropriate Use and Operationalization of Adherence to Digital Cognitive Behavioral Therapy for Depression and Anxiety in Youth: Systematic Review. JMIR Ment Health 2022; 9:e37640. [PMID: 35976180 PMCID: PMC9434387 DOI: 10.2196/37640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 06/07/2022] [Accepted: 06/16/2022] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Digital, self-guided cognitive behavioral therapy (CBT) interventions circumvent many barriers to in-person therapy for young people (aged 12-24 years), although adherence to these interventions is low. The absence or insufficient disclosure of recommendations or instructions for appropriate use may account for this. As such, many young people may not self-administer these interventions appropriately or receive the optimal degree of treatment. OBJECTIVE This systematic review aims to synthesize the literature on digital CBT for depression and anxiety in young people to describe how appropriate use has been defined and communicated to users as instructions for use, to describe how adherence has been measured, and to determine the associations between adherence and treatment outcomes. METHODS A systematic review was conducted with 2 reviewers (SHL and MRA) extracting data independently. Overall, 4 electronic databases (Embase, MEDLINE, PsycINFO, and Cochrane Library) were searched in April 2021 for studies that met the following inclusion criteria: participants aged between 12 and 24 years, evaluated a digital CBT intervention targeting depression or anxiety, and reported instructions or recommendations for use or measures of adherence. Studies that evaluated non-CBT interventions or cognitive- or behavioral-only interventions were excluded. Methodological quality was assessed using the Cochrane Risk of Bias Tool and the Integrated Quality Criteria for the Review of Multiple Study Designs. RESULTS There were 32 manuscripts that met the inclusion criteria, of which 28 (88%) were unique studies (N=16,578 youths). Definitions of appropriate use varied among the different interventions in terms of intended recipients, duration and frequency of use, and the features used to support engagement and adherence to appropriate use definitions. Reporting of appropriate use definitions in studies was inconsistent, with no study systematically describing components of appropriate use or providing information on how recommendations for use were relayed to users. Most often, definitions of appropriate use were derived from the study protocol and descriptions of intervention features. Adherence was mostly operationalized as the degree of intervention completion; however, reporting of adherence data was heterogeneous. There was little evidence of an association between degree of use and outcomes in the 9 studies that examined this. CONCLUSIONS Definitions of appropriate use are unique to each digital CBT intervention. However, statements of appropriate use are not systematically reported in the literature. Furthermore, the extent to which recommendations for use are communicated to users is not routinely reported. Despite unique definitions of appropriate use, adherence was most often generically operationalized as the degree of intervention completion and was not consistently associated with outcomes. We proposed a framework to promote systematic reporting of definitions of appropriate use for digital interventions to provide guidance to users and to assist the development of appropriate and nuanced measures of adherence. TRIAL REGISTRATION PROSPERO CRD42020208668; https://tinyurl.com/4bu2yram.
Collapse
Affiliation(s)
- Sophie H Li
- Black Dog Institute and School of Psychology, The University of New South Wales, Randwick, Australia
| | - Melinda R Achilles
- Black Dog Institute, The University of New South Wales, Randwick, Australia
| | - Aliza Werner-Seidler
- Black Dog Institute and School of Psychology, The University of New South Wales, Randwick, Australia
| | - Joanne R Beames
- Black Dog Institute, The University of New South Wales, Randwick, Australia
| | | | - Bridianne O'Dea
- Black Dog Institute, The University of New South Wales, Randwick, Australia
| |
Collapse
|
75
|
Smith IS, Wallace R, Wellecke C, Bind MA, Weihs KL, Bei B, Wiley JF. Assessing an Internet-Delivered, Emotion-Focused Intervention Compared With a Healthy Lifestyle Active Control Intervention in Improving Mental Health in Cancer Survivors: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e36658. [PMID: 35896021 PMCID: PMC9377468 DOI: 10.2196/36658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 06/26/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Cancer survivors are vulnerable to experiencing symptoms of anxiety and depression and may benefit from accessible interventions focused on improving emotion regulation. CanCope Mind (CM) was developed as an internet-delivered intervention adapted from the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders to improve emotion regulation and support the mental health of cancer survivors. OBJECTIVE This protocol aims to provide an outline of the CanCope Study, a trial comparing the efficacy of a Unified Protocol-adapted internet-delivered intervention (CM) designed for cancer survivors compared with an active control condition-an internet-delivered healthy lifestyle intervention, CanCope Lifestyle (CL). The primary aim is to assess and compare the efficacy of both interventions in improving emotion regulation, anxiety and depressive symptoms, and quality of life. The secondary aims involve assessing the mechanisms of the CM intervention. METHODS This trial is a 2-arm randomized controlled trial that allocates cancer survivors to either CM or CL. Both interventions comprise 4 web-based modules and are expected to take participants at least 8 weeks to complete. Participants' mental and physical health will be assessed via self-reported surveys at baseline (T0), between each module (T1, T2, and T3), immediately after the intervention (T4), and at 3-month follow-up (T5). The study aims to recruit 110 participants who have completed T4. RESULTS The CanCope study began recruitment in September 2020. A total of 224 participants have been randomized to the CM (n=110, 49.1%) and CL (n=114, 50.9%) groups. CONCLUSIONS This is one of the first trials to develop and investigate the efficacy of a web-based intervention for cancer survivors that specifically targets emotion regulation. TRIAL REGISTRATION Australian Clinical Trials ACTRN12620000943943; https://tinyurl.com/b3z9cjsp. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/36658.
Collapse
Affiliation(s)
- Isabelle S Smith
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Rebecca Wallace
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Cornelia Wellecke
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Marie-Abèle Bind
- Biostatistics Center, Massachusetts General Hospital, Boston, MA, United States
| | - Karen L Weihs
- Department of Psychiatry, College of Medicine, University of Arizona, Tucson, AZ, United States
| | - Bei Bei
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Joshua F Wiley
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
- Peter MacCallum Cancer Centre, Melbourne, Australia
| |
Collapse
|
76
|
Thomas M, Henderson D, Trudel C, Thomas N. Utility of a Community-Based Dementia Resource Website: Mixed-Methods Study (Preprint). JMIR Aging 2022; 6:e40762. [PMID: 37079355 PMCID: PMC10160937 DOI: 10.2196/40762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 02/09/2023] [Accepted: 03/04/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND Many individuals living with dementia want to live in their own homes for as long as possible. To do so, they frequently require assistance with activities of daily living, which is often provided by friends and relatives acting as informal care partners. In Canada, many informal care partners are currently overworked and overwhelmed. Although community-based dementia-inclusive resources are available to support them, care partners often struggle to find them. Dementia613.ca was created to make the process of finding community dementia-inclusive resources simpler and more straightforward by bringing them together in one eHealth website. OBJECTIVE The objective of our study was to determine if dementia613.ca is meeting the goal of connecting care partners and persons living with dementia to dementia-inclusive resources in their community. METHODS A review and assessment of the website was conducted using 3 evaluation methods: web analytics, questionnaires, and task analysis. Google Analytics was used to collect data related to website use over a 9-month period. Data on site content and user characteristics were collected. Furthermore, 2 web-based self-administered questionnaires were developed: one intended for care partners and persons living with dementia, and the other intended for businesses and organizations interested in serving persons living with dementia. Both gathered data on user characteristics and included standard questions used in website evaluations. Responses were collected over a 6-month period. Scenarios, tasks, and questions were developed for the moderated, remote, and task-analysis sessions. These tasks and questions determined how effectively persons living with dementia and their care partners can use dementia613.ca. Overall, 5 sessions were held with persons experiencing moderate cognitive decline and with care partners of persons living with dementia. RESULTS This evaluation showed that the idea behind dementia613.ca is strong and appeals to persons living with dementia, their care partners, and the businesses and organizations serving this market. Participants indicated that it is a useful community resource that meets a previously unfulfilled need in the area, and highlighted the benefits of bringing community resources together on 1 website. In our questionnaire, >60% (19/29, 66%) of people living with dementia and their care partners and 70% (7/10) of businesses and organizations agreed that the website made it easier to find relevant dementia-inclusive resources. There is room for improvement; participants indicated that the navigation and search features could be further developed. CONCLUSIONS We believe that the dementia613.ca model could be used to inspire and guide the creation of dementia resource websites in other regions in Ontario and beyond. The framework behind it is generalizable and could be replicated to help care partners and persons living with dementia find local resources more easily.
Collapse
Affiliation(s)
- Missy Thomas
- School of Industrial Design, Department of Engineering and Design, Carleton University, Ottawa, ON, Canada
- Bruyère Research Institute, Ottawa, ON, Canada
| | - Dean Henderson
- The Dementia Society of Ottawa and Renfrew County, Ottawa, ON, Canada
| | - Chantal Trudel
- School of Industrial Design, Department of Engineering and Design, Carleton University, Ottawa, ON, Canada
- Bruyère Research Institute, Ottawa, ON, Canada
| | - Neil Thomas
- Bruyère Research Institute, Ottawa, ON, Canada
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada
| |
Collapse
|
77
|
Ezike NC, Ames Boykin A, Dobbs PD, Mai H, Primack BA. Exploring Factors That Predict Marketing of e-Cigarette Products on Twitter: Infodemiology Approach Using Time Series. JMIR INFODEMIOLOGY 2022; 2:e37412. [PMID: 37113447 PMCID: PMC9987194 DOI: 10.2196/37412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 06/04/2022] [Accepted: 06/17/2022] [Indexed: 04/29/2023]
Abstract
Background Electronic nicotine delivery systems (known as electronic cigarettes or e-cigarettes) increase risk for adverse health outcomes among naïve tobacco users, particularly youth and young adults. This vulnerable population is also at risk for exposed brand marketing and advertisement of e-cigarettes on social media. Understanding predictors of how e-cigarette manufacturers conduct social media advertising and marketing could benefit public health approaches to addressing e-cigarette use. Objective This study documents factors that predict changes in daily frequency of commercial tweets about e-cigarettes using time series modeling techniques. Methods We analyzed data on the daily frequency of commercial tweets about e-cigarettes collected between January 1, 2017, and December 31, 2020. We fit the data to an autoregressive integrated moving average (ARIMA) model and unobserved components model (UCM). Four measures assessed model prediction accuracy. Predictors in the UCM include days with events related to the US Food and Drug Administration (FDA), non-FDA-related events with significant importance such as academic or news announcements, weekday versus weekend, and the period when JUUL maintained an active Twitter account (ie, actively tweeting from their corporate Twitter account) versus when JUUL stopped tweeting. Results When the 2 statistical models were fit to the data, the results indicate that the UCM was the best modeling technique for our data. All 4 predictors included in the UCM were significant predictors of the daily frequency of commercial tweets about e-cigarettes. On average, brand advertisement and marketing of e-cigarettes on Twitter was higher by more than 150 advertisements on days with FDA-related events compared to days without FDA events. Similarly, more than 40 commercial tweets about e-cigarettes were, on average, recorded on days with important non-FDA events compared to days without such events. We also found that there were more commercial tweets about e-cigarettes on weekdays than on weekends and more commercial tweets when JUUL maintained an active Twitter account. Conclusions e-Cigarette companies promote their products on Twitter. Commercial tweets were significantly more likely to be posted on days with important FDA announcements, which may alter the narrative about information shared by the FDA. There remains a need for regulation of digital marketing of e-cigarette products in the United States.
Collapse
Affiliation(s)
- Nnamdi C Ezike
- College of Education and Health Professions University of Arkansas Fayetteville, AR United States
| | - Allison Ames Boykin
- College of Education and Health Professions University of Arkansas Fayetteville, AR United States
| | - Page D Dobbs
- College of Education and Health Professions University of Arkansas Fayetteville, AR United States
| | - Huy Mai
- College of Engineering University of Arkansas Fayetteville, AR United States
| | - Brian A Primack
- College of Public Health and Human Sciences Oregon State University Corvallis, OR United States
| |
Collapse
|
78
|
Clemmensen LKH, Lønfeldt N, Das S, Lund NL, Uhre V, Mora-Jensen AC, Pretzman L, Uhre CF, Ritter M, Korsbjerg NLJ, Hagstrøm J, Thoustrup CL, Clemmensen I, Plessen KJ, Pagsberg A. Associations Between OCD Severity and Focal Features in Children and Adolescents: A Statistical and Machine Learning Analysis Plan (Preprint). JMIR Res Protoc 2022; 11:e39613. [DOI: 10.2196/39613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 07/27/2022] [Accepted: 07/30/2022] [Indexed: 11/13/2022] Open
|
79
|
Yu M, Yang MR. Effectiveness and Utility of Virtual Reality Infection Control Simulation for Children With COVID-19: Quasi-Experimental Study. JMIR Serious Games 2022; 10:e36707. [PMID: 35575818 PMCID: PMC9150730 DOI: 10.2196/36707] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 03/26/2022] [Accepted: 05/13/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND It is essential that nurses quickly learn the proper methods for preventing and controlling nosocomial infection and managing intensive care patients during the COVID-19 pandemic, including the donning and doffing of personal protective equipment (PPE). Virtual reality (VR) simulation offers the advantage of learning in a safe environment with a sense of realism similar to that of an actual clinical setting and has been reported to enhance self-efficacy in infection control, safety performance, and learning satisfaction among students. OBJECTIVE This study aims to develop a virtual reality infection control simulation (VRICS) program regarding donning and doffing of PPE and respiratory care for pediatric patients admitted to an isolation unit for COVID-19 and to identify the effects of the program on PPE knowledge, infection control performance, and self-efficacy for nursing students. Additionally, the realism of the VRICS program and the students' level of satisfaction with the program were assessed. METHODS This was a quasi-experimental study based on a controlled pretest-posttest design. Third- and fourth-year nursing students were divided into an experimental group (n=25) who participated in a VRICS program and a control group (n=25) with no participation. Data were collected from November 13 to December 10, 2021, and analyzed using descriptive statistics and the t test, paired t test, Mann-Whitney U test, and Wilcoxon matched-pair signed-rank test. The VRICS program consisted of a prebriefing, including direct practice of donning and doffing PPE, VR simulation, and debriefing. The VR simulation comprised 3 sessions: donning and inspection of PPE in the dressing room before entering the negative-pressure isolation unit; assessing for suction care, nasopharyngeal suctioning, and checking of COVID-19 patients in the negative-pressure isolation unit; and doffing PPE in the dressing room. The total execution time for the program was 180 min. RESULTS Compared with the control group, the experimental group showed significantly greater improvements in PPE knowledge (z=-3.28, P<.001), infection control performance (t48=4.89, P<.001), and self-efficacy (t36.2=4.93, P<.001). The experimental group's mean scores for realistic immersion and learner satisfaction were 4.49 (SD 0.50) points and 4.75 (SD 0.38) points (on a 5-point Likert scale), respectively. CONCLUSIONS The VR simulation training program involving pediatric COVID-19 patients combined skills training effectively and enhanced theoretical knowledge, respiratory care skills, and infectious disease preparedness. Thus, it could be applied to training nurses to respond more effectively to public health situations involving infectious diseases, including the COVID-19 pandemic.
Collapse
Affiliation(s)
- Mi Yu
- College of Nursing, Institute of Health Sciences, Gyeongsang National University, Jinju, Republic of Korea
| | - Mi Ran Yang
- Department of Nursing, Kwangju Health University, Kwangju, Republic of Korea
| |
Collapse
|
80
|
Paulauskaite L, Totsika V, Rivas C. Relationships and Sex Education outcomes for students with intellectual disability: protocol for development of a Core Outcome Set (Preprint). JMIR Res Protoc 2022; 11:e39921. [DOI: 10.2196/39921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 10/04/2022] [Accepted: 10/13/2022] [Indexed: 11/07/2022] Open
|
81
|
Manton D, Williams M, Hayen A. The Bunya Project: Protocol to develop culturally informed curriculum (Preprint). JMIR Res Protoc 2022; 12:e39864. [PMID: 37200069 DOI: 10.2196/39864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 02/19/2023] [Accepted: 03/14/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Indigenous peoples live across all continents, representing approximately 90 nations and cultures and 476 million people. There have long been clear statements about the rights of Indigenous peoples to self-determine services, policies, and resource allocations that affect our lives, particularly via the United Nations Declaration on the Rights of Indigenous Peoples. An area for urgent improvement is curricula that train the predominantly non-Indigenous health workforce about their responsibilities and that offer practical strategies to use when engaging with Indigenous peoples and issues. OBJECTIVE The Bunya Project is designed to advance Indigenous community-led teaching and evaluation of the embeddedness of strategies to achieve an Indigenous Graduate Attribute in Australia. The project centers the relationships with Aboriginal community services to lead education design relating to Indigenous peoples. The project aims to articulate community recommendations for university education in allied health in the usable format of digital stories to create culturally informed andragogy, curriculum, and assessment measures for use in teaching. It also aims to understand the impact of this work on student attitudes and knowledge about Indigenous peoples' allied health needs. METHODS Multilayered project governance was established, along with a 2-stage process using mixed methods participatory action research and critical reflection, using the reflective cycle by Gibbs. The first stage, preparing the soil, used community engagement, drew on lived experience, encouraged critical self-reflection, embodied reciprocity, and demanded working collectively. The second stage, planting the seed, requires more critical self-reflection, the development of community data through interviews and focus group discussions, the development of resources with an academic working group and community participants, the implementation of those resources with student feedback, the analysis of the feedback from students and community members, and reflection. RESULTS The protocol for the first stage, preparing the soil, is complete. The results of the first stage are the relationships built and the trust earned and gained, and it has resulted in the development of the planting the seed protocol. As of February 2023, we have recruited 24 participants. We will analyze data shortly and expect to publish the results in 2024. CONCLUSIONS The readiness of non-Indigenous staff to engage with Indigenous communities has not been ascertained by Universities Australia, nor can it be assured. Staff preparation and skills to support the curriculum, create a safe learning environment, and develop teaching and learning strategies to guide academics to recognize that how students learn is as important as the content students learn. This learning has broad implications and benefits for staff and students within their professional practice and for lifelong learning. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/39864.
Collapse
|
82
|
Kirwan M, Chiu CL, Laing T, Chowdhury N, Gwynne K. Delivering an online clinician led group exercise intervention for older adults with type 2 diabetes: single arm pre-post intervention (Preprint). J Med Internet Res 2022; 24:e39800. [PMID: 36149745 PMCID: PMC9547336 DOI: 10.2196/39800] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/14/2022] [Accepted: 08/31/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Morwenna Kirwan
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Macquarie Park, Australia
| | - Christine L Chiu
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Macquarie Park, Australia
| | | | | | - Kylie Gwynne
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Macquarie Park, Australia
| |
Collapse
|
83
|
Eilert N, Wogan R, Leen A, Richards D. Internet-Delivered Interventions for Depression and Anxiety Symptoms in Children and Young People: Systematic Review and Meta-analysis. JMIR Pediatr Parent 2022; 5:e33551. [PMID: 35551071 PMCID: PMC9136650 DOI: 10.2196/33551] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 01/23/2022] [Accepted: 02/07/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Mental health difficulties in children and adolescents are highly prevalent; however, only a minority receive adequate mental health care. Internet-delivered interventions offer a promising opportunity to increase access to mental health treatment. Research has demonstrated their effectiveness as a treatment for depression and anxiety in adults. This work provides an up-to-date examination of the available intervention options and their effectiveness for children and young people (CYP). OBJECTIVE In this systematic review and meta-analysis, we aimed to determine the evidence available for the effectiveness of internet-delivered interventions for treating anxiety and depression in CYP. METHODS Systematic literature searches were conducted throughout November 2020 using PubMed, PsycINFO, and EBSCO academic search complete electronic databases to find outcome trials of internet-delivered interventions treating symptoms of anxiety and/or depression in CYP by being either directly delivered to the CYP or delivered via their parents. Studies were eligible for meta-analysis if they were randomized controlled trials. Risk of bias and publication biases were evaluated, and Hedges g between group effect sizes evaluating intervention effects after treatment were calculated. Meta-analyses used random-effects models as per protocol. RESULTS A total of 23 studies met the eligibility criteria for the systematic review, of which 16 were included in the meta-analyses, including 977 participants in internet-delivered treatment conditions and 1008 participants in control conditions across 21 comparisons. Random-effects models detected a significant small effect for anxiety symptoms (across 20 comparisons; Hedges g=-0.25, 95% CI -0.38 to -0.12; P<.001) and a small but not significant effect for depression (across 13 comparisons; Hedges g=-0.27, 95% CI -0.55 to 0.01; P=.06) in favor of internet-delivered interventions compared with control groups. Regarding secondary outcomes, there was a small effect of treatment across 9 comparisons for impaired functioning (Hedges g=0.52, 95% CI 0.24-0.80; P<.001), and 5 comparisons of quality of life showed no effect (Hedges g=-0.01, 95% CI -0.23 to 0.21; P=.94). CONCLUSIONS The results show that the potential of internet-delivered interventions for young people with symptoms of anxiety or depression has not been tapped into to date. This review highlights an opportunity for the development of population-specific interventions and their research to expand our current knowledge and build an empirical base for digital interventions for CYP. TRIAL REGISTRATION PROSPERO CRD42020220171; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=220171.
Collapse
Affiliation(s)
- Nora Eilert
- e-Mental Health Group, School of Psychology, University of Dublin Trinity College, Dublin, Ireland
- SilverCloud Science, SilverCloud Health, Dublin, Ireland
| | - Rebecca Wogan
- SilverCloud Science, SilverCloud Health, Dublin, Ireland
| | - Aisling Leen
- SilverCloud Science, SilverCloud Health, Dublin, Ireland
| | - Derek Richards
- e-Mental Health Group, School of Psychology, University of Dublin Trinity College, Dublin, Ireland
- SilverCloud Science, SilverCloud Health, Dublin, Ireland
| |
Collapse
|
84
|
Scheutzow J, Attoe C, Harwood J. Acceptability of Web-Based Mental Health Interventions in the Workplace: Systematic Review. JMIR Ment Health 2022; 9:e34655. [PMID: 35544305 PMCID: PMC9133994 DOI: 10.2196/34655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 01/31/2022] [Accepted: 02/08/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Web-based interventions have proven to be effective not only in clinical populations but also in the occupational setting. Recent studies conducted in the work environment have focused on the effectiveness of these interventions. However, the role of employees' acceptability of web-based interventions and programs has not yet enjoyed a similar level of attention. OBJECTIVE The objective of this systematic review was to conduct the first comprehensive study on employees' level of acceptability of web-based mental health interventions based on direct and indirect measures, outline the utility of different types of web-based interventions for work-related mental health issues, and build a research base in the field. METHODS The search was conducted between October 2018 and July 2019 and allowed for any study design. The studies used either qualitative or quantitative data sources. The web-based interventions were generally aimed at supporting employees with their mental health issues. The study characteristics were outlined in a table as well as graded based on their quality using a traffic light schema. The level of acceptability was individually rated using commonly applied methods, including percentile quartiles ranging from low to very high. RESULTS A total of 1303 studies were identified through multiple database searches and additional resources, from which 28 (2%) were rated as eligible for the synthesis. The results of employees' acceptability levels were mixed, and the studies were very heterogeneous in design, intervention characteristics, and population. Approximately 79% (22/28) of the studies outlined acceptability measures from high to very high, and 54% (15/28) of the studies reported acceptability levels from low to moderate (overlap when studies reported both quantitative and qualitative results). Qualitative studies also provided insights into barriers and preferences, including simple and tailored application tools as well as the preference for nonstigmatized language. However, there were multiple flaws in the methodology of the studies, such as the blinding of participants and personnel. CONCLUSIONS The results outline the need for further research with more homogeneous acceptability studies to draw a final conclusion. However, the underlying results show that there is a tendency toward general acceptability of web-based interventions in the workplace, with findings of general applicability to the use of web-based mental health interventions.
Collapse
Affiliation(s)
- Johanna Scheutzow
- Department of Psychosis, Institute of Psychiatry, Psychology and Neuroscience, School of Academic Psychiatry, King's College London, London, United Kingdom
| | - Chris Attoe
- Department of Psychosis, Institute of Psychiatry, Psychology and Neuroscience, School of Academic Psychiatry, King's College London, London, United Kingdom.,Maudsley Learning, South London & Maudsley NHS Foundation Trust, London, United Kingdom
| | - Joshua Harwood
- Maudsley Learning, South London & Maudsley NHS Foundation Trust, London, United Kingdom
| |
Collapse
|
85
|
Boccardi A, Wu F, Pearlman J, Mhatre A. Elderly wheelchair users recommend age-friendly design improvements to a mHealth wheelchair maintenance application in a mixed-methods study (Preprint). JMIR Aging 2022; 5:e39301. [PMID: 36256830 PMCID: PMC9627462 DOI: 10.2196/39301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 08/27/2022] [Accepted: 08/29/2022] [Indexed: 11/22/2022] Open
Abstract
Background Wheelchair part failures have doubled over the past decade. Preventative wheelchair maintenance reduces wheelchair failures and prevents user consequences. We are developing a smartphone app called WheelTrak, which alerts users when maintenance is required, to encourage maintenance practices and compliance. Objective This mixed methods study aimed to develop a wheelchair maintenance app using broad stakeholder advice and investigate older adults’ interaction experience with the app and their perceived barriers to and facilitators of maintenance. Methods Interviews were conducted with stakeholders, including mobility device users, to generate needs statements and app specifications. The app was designed in 2 stages. Stage 1 involved the development of the app according to the specifications and evaluation of the app interface by lead users. Stage 2 included the revision of the app screens and manual functionality testing. Usability testing and semistructured interviews were conducted with older wheelchair and scooter users. The System Usability Scale was used to measure app usability. Results Interviews with power and manual wheelchair users (37/57, 65%), wheelchair service providers (15/57, 26%), manufacturers (2/57, 4%), seating and mobility researchers (1/57, 2%), and insurance plan providers (2/57, 4%) informed the needs and specifications of the app technology. The 2-stage development process delivered a fully functional app that met the design specifications. In total, 12 older adults (mean age 74.2, SD 9.1 years; n=10, 83% women; and n=2, 17% men) participated in the usability testing study. Of the 12 participants, 9 (75%) agreed to use WheelTrak for preventative maintenance. WheelTrak scored an average System Usability Scale score of 60.25 (SD 16). Four overarching themes were identified: WheelTrak app improvements, barriers to maintenance, consequences related to mobility device failure, and smart technology use and acceptance. Older adults preferred the simplicity, readability, personalization, and availability of educational resources in the app. Barriers to maintenance pertained to health issues and lack of maintenance knowledge among older adults. Facilitators of maintenance included notification for maintenance, app connectivity with the service provider, reporting of device failure, and the presence of a caregiver for maintenance. Conclusions This study highlighted age-friendly design improvements to the app, making it easy to be used and adopted by older wheelchair users. The WheelTrak app has close to average system usability. Additional usability testing will be conducted following app revision in the future.
Collapse
Affiliation(s)
- Alyssa Boccardi
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Fangzheng Wu
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Jon Pearlman
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Anand Mhatre
- Occupational Therapy Division, Ohio State University Wexner Medical Center, Columbus, OH, United States
| |
Collapse
|
86
|
Pit S, Ramsden R, Tan AJ, Payne K, Barr J, Eames B, Edwards M, Colbran R. 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? JMIR Hum Factors 2022; 9:e35094. [PMID: 35499866 PMCID: PMC9112088 DOI: 10.2196/35094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 12/11/2021] [Accepted: 12/28/2021] [Indexed: 11/13/2022] Open
Abstract
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.
Collapse
Affiliation(s)
- Sabrina Pit
- New South Wales Rural Doctors Network, Hamilton, Australia
- School of Medicine, Western Sydney University, Campbelltown, Australia
- University Centre for Rural Health, Faculty of Medicine and Health Sciences, University of Sydney, Lismore, Australia
| | - Robyn Ramsden
- New South Wales Rural Doctors Network, Hamilton, Australia
| | - Aaron Jh Tan
- New South Wales Rural Doctors Network, Hamilton, Australia
| | - Kristy Payne
- New South Wales Rural Doctors Network, Hamilton, Australia
| | - James Barr
- New South Wales Rural Doctors Network, Hamilton, Australia
| | - Benjamin Eames
- New South Wales Rural Doctors Network, Hamilton, Australia
| | - Mike Edwards
- New South Wales Rural Doctors Network, Hamilton, Australia
| | | |
Collapse
|
87
|
Yu H, Du R, Wang M, Yu F, Yang J, Jiao L, Wang Z, Liu H, Wu P, Bärnighausen T, Xue L, Wang C, McMahon S, Geldsetzer P, Chen S. The provision of COVID-19 vaccines developed in China to other countries: A cross-sectional online survey on the views of the Chinese public. JMIR Public Health Surveill 2022; 8:e33484. [PMID: 35483084 PMCID: PMC9177168 DOI: 10.2196/33484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 02/22/2022] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND COVID-19 vaccines are in short supply globally. China was among the first countries to pledge supplies of the COVID-19 vaccine as a global public product, and to date the country has provided more than 600 million vaccines to more than 200 countries and regions with low COVID-19 vaccination rates. Understanding the public's attitude in China towards the global distribution of COVID-19 vaccines could inform global and national decisions, policies and debates. OBJECTIVE The aim of this study was to determine the attitudes of adults living in China regarding the global allocation of COVID-19 vaccines developed in China, and how these attitudes vary across provinces and by sociodemographic characteristics. METHODS We conducted a cross-sectional online survey among adults registered with the survey company KuRunData. The survey asked participants 31 questions on their attitudes regarding the global allocation of COVID-19 vaccines developed in China. We disaggregated responses by province and sociodemographic characteristics. All analyses used survey sampling weights. RESULTS A total of 10,000 participants completed the questionnaire. Participants generally favored providing COVID-19 vaccines to foreign countries before fully fulfilling domestic needs (75.6%, 95% CI: 74.6% - 76.5%). Women (76.8%, OR = 1.18, 95% CI: 1.07 - 1.32, P = .002) and those living in rural areas (76.8%, OR = 1.13, 95% CI: 1.01 - 1.27, P = .03) were especially likely to hold this opinion. Most respondents preferred providing financial support through international platforms rather than directly offering support to individual countries (72.1%, 95% CI: 71.0% - 73.1%), while for vaccine products they preferred direct provision to relevant countries instead of via a delivery platform such as COVAX (77.3%, 95% CI: 76.3% - 78.2%). CONCLUSIONS Among our survey sample, we find that adults are generally supportive of the international distribution of COVID-19 vaccines, which may encourage policy makers to support and implement the distribution of COVID-19 vaccines developed in China globally. Conducting similar surveys in other countries could help align policymakers' actions on COVID-19 vaccine distribution with the preferences of their constituencies. CLINICALTRIAL
Collapse
Affiliation(s)
- Hanzhi Yu
- School of Public Affairs, Zhejiang University, Hangzhou, CN
| | - Runming Du
- Department of Global Health, School of Public Health, Peking University, Beijing, CN
| | - Minmin Wang
- Peking University Cancer Hospital & Institute, Beijing, CN
| | - Fengyun Yu
- State Key Laboratory of Medical Molecular Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, CN
| | - Juntao Yang
- State Key Laboratory of Medical Molecular Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, CN
| | | | - Zhuoran Wang
- Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, CN
| | - Haitao Liu
- Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, CN
| | - Peixin Wu
- Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, CN
| | - Till Bärnighausen
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Postfach 10 57 60 69047 Heidelberg, Heidelberg, DE
| | - Lan Xue
- School of Public Policy and Management, Tsinghua University, Beijing, CN
| | - Chen Wang
- Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, CN
| | - Shannon McMahon
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Postfach 10 57 60 69047 Heidelberg, Heidelberg, DE
| | - Pascal Geldsetzer
- Division of Primary Care and Population Health, Department of Medicine, Stanford University, Stanford, US
| | - Simiao Chen
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Postfach 10 57 60 69047 Heidelberg, Heidelberg, DE
| |
Collapse
|
88
|
Wannheden C, Åberg-Wennerholm M, Dahlberg M, Revenäs Å, Tolf S, Eftimovska E, Brommels M. Digital Health Technologies Enabling Partnerships in Chronic Care Management: A Scoping Review (Preprint). J Med Internet Res 2022; 24:e38980. [PMID: 35916720 PMCID: PMC9379797 DOI: 10.2196/38980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 06/02/2022] [Accepted: 06/16/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Carolina Wannheden
- Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Matilda Åberg-Wennerholm
- Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Marie Dahlberg
- Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Åsa Revenäs
- Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
- Division of Physiotherapy, School of Health Care and Social Welfare, Mälardalen University, Västerås, Sweden
- Center for Clinical Research, County of Västmanland, Uppsala University, Västerås, Sweden
| | - Sara Tolf
- Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Elena Eftimovska
- Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Mats Brommels
- Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
89
|
Tour SK, Thompson A, Howard RA, Larkin M. Experiences of Blogging About Visible and Long-term Skin Conditions: Interpretative Phenomenological Analysis. JMIR DERMATOLOGY 2022; 5:e29980. [PMID: 37632861 PMCID: PMC10334883 DOI: 10.2196/29980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 08/30/2021] [Accepted: 10/31/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Skin conditions can detract from people's quality of life, much like conditions such as cancer, chronic pain, and depression. Visible skin conditions can lead to risk of stigmatization. It is acknowledged that there is a lack of available psychosocial support for people living with chronic skin conditions. One way in which individuals with long-term conditions are self-managing and providing peer support is through blogging and exchanging information on the web. To date, no research has specifically investigated how individuals with skin conditions experience the use blogging for self-management. OBJECTIVE This study sought to investigate the experiences of individuals with visible, long-term skin conditions when blogging about their conditions. METHODS A systematic blog search and a short survey were used for recruitment. A total of 4 participants took part in email interviews, which were analyzed using interpretative phenomenological analysis (IPA). Skin conditions included alopecia, psoriasis, and hirsutism. The content of these individuals' blogs was also analyzed using a qualitative template method derived from the IPA analysis. RESULTS The interviews and accounts revealed a clear sense of uncertainty about the course of the bloggers' skin conditions. This appeared to be associated with feelings of distress and isolation, searching for treatments, and ultimately a sense of defeat. The data revealed that blogging provided a space where this sense of defeat was managed and challenged. Posting on the web facilitated connection with others and enabled support networks to be established that assisted in challenging the feelings of isolation experienced. The data demonstrate the important role that blogging played for these participants in developing a sense of acceptance of their condition. CONCLUSIONS Blogging may provide a way for individuals to self-manage distress associated with visible skin conditions. It may provide similar benefits to those known to be derived from emotional disclosure that occurs during writing, with an added peer support dimension. Blogging has occurred naturalistically on web-based forums, and this study demonstrates how this form of interaction may warrant adaptation for use with web-based psychosocial interventions for people living with skin conditions. This study had a limited sample of 4 bloggers; therefore, further exploration would be needed to consider the utility of this approach.
Collapse
Affiliation(s)
- Selina K Tour
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Andrew Thompson
- South Wales National Health Service Clinical Psychology Training Programme, Cardiff University, Cardiff, United Kingdom
| | - Ruth A Howard
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Michael Larkin
- School of Life and Health Sciences, Aston University, Birmingham, United Kingdom
| |
Collapse
|
90
|
Boukobza A, Burgun A, Roudier B, Tsopra R. Deep neural networks for simultaneously capturing public topics and sentiments during a pandemic. Application to a COVID-19 tweet dataset. JMIR Med Inform 2022; 10:e34306. [PMID: 35533390 PMCID: PMC9135113 DOI: 10.2196/34306] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 02/14/2022] [Accepted: 04/21/2022] [Indexed: 11/24/2022] Open
Abstract
Background Public engagement is a key element for mitigating pandemics, and a good understanding of public opinion could help to encourage the successful adoption of public health measures by the population. In past years, deep learning has been increasingly applied to the analysis of text from social networks. However, most of the developed approaches can only capture topics or sentiments alone but not both together. Objective Here, we aimed to develop a new approach, based on deep neural networks, for simultaneously capturing public topics and sentiments and applied it to tweets sent just after the announcement of the COVID-19 pandemic by the World Health Organization (WHO). Methods A total of 1,386,496 tweets were collected, preprocessed, and split with a ratio of 80:20 into training and validation sets, respectively. We combined lexicons and convolutional neural networks to improve sentiment prediction. The trained model achieved an overall accuracy of 81% and a precision of 82% and was able to capture simultaneously the weighted words associated with a predicted sentiment intensity score. These outputs were then visualized via an interactive and customizable web interface based on a word cloud representation. Using word cloud analysis, we captured the main topics for extreme positive and negative sentiment intensity scores. Results In reaction to the announcement of the pandemic by the WHO, 6 negative and 5 positive topics were discussed on Twitter. Twitter users seemed to be worried about the international situation, economic consequences, and medical situation. Conversely, they seemed to be satisfied with the commitment of medical and social workers and with the collaboration between people. Conclusions We propose a new method based on deep neural networks for simultaneously extracting public topics and sentiments from tweets. This method could be helpful for monitoring public opinion during crises such as pandemics.
Collapse
Affiliation(s)
- Adrien Boukobza
- Université Paris Cité, Sorbonne Université, Inserm, Centre de Recherche des Cordeliers, F-75006 Paris, FR.,Inria, HeKA, PariSanté Campus, Paris, FR.,Department of Medical Informatics, AP-HP, Hôpital Européen Georges-Pompidou, F-75015 Paris, FR
| | - Anita Burgun
- Université Paris Cité, Sorbonne Université, Inserm, Centre de Recherche des Cordeliers, F-75006 Paris, FR.,Inria, HeKA, PariSanté Campus, Paris, FR.,Department of Medical Informatics, AP-HP, Hôpital Européen Georges-Pompidou, F-75015 Paris, FR
| | | | - Rosy Tsopra
- Université Paris Cité, Sorbonne Université, Inserm, Centre de Recherche des Cordeliers, F-75006 Paris, FR.,Inria, HeKA, PariSanté Campus, Paris, FR.,Department of Medical Informatics, AP-HP, Hôpital Européen Georges-Pompidou, F-75015 Paris, FR
| |
Collapse
|
91
|
Sharma P, Sinicrope AR, Sinicrope P, Brockman TA, Reinicke NM, West IW, Wiepert LM, Glasgow AE, Sangaralingham LR, Holland AL, Patten CA. Patient Telemedicine Perceptions During the COVID-19 Pandemic within a Multi-State Medical Institution: A Qualitative Study. JMIR Form Res 2022; 6:e37012. [PMID: 35452401 PMCID: PMC9109780 DOI: 10.2196/37012] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/22/2022] [Accepted: 04/21/2022] [Indexed: 02/06/2023] Open
Abstract
Background During the COVID-19 pandemic, to prevent the spread of the virus, federal regulatory barriers around telemedicine were lifted, and health care institutions encouraged patients to use telemedicine, including video appointments. Many patients, however, still chose face-2-face (f2f) appointments for nonemergent clinical care. Objective We explored patients’ personal and environmental barriers to the use of video appointments from April 2020 to December 2020. Methods We conducted qualitative telephone interviews of Mayo Clinic patients who attended f2f appointments at the Mayo Clinic from April 2020 to December 2020 but did not utilize Mayo Clinic video appointment services during that time frame. Results We found that, although most patients were concerned about preventing COVID-19 transmission, they trusted Mayo Clinic to keep them safe when attending f2f appointments. Many expressed that a video appointment made it difficult to establish rapport with their providers. Other common barriers to video appointments were perceived therapeutic benefits of f2f appointments, low digital literacy, and concerns about privacy and security. Conclusions Our study provides an in-depth investigation into barriers to engaging in video appointments for nonemergent clinical care in the context of the COVID-19 pandemic. Our findings corroborate many barriers prevalent in the prepandemic literature and suggest that rapport barriers need to be analyzed and problem-solved at a granular level.
Collapse
Affiliation(s)
- Pravesh Sharma
- Behavioral Health Research Program, Psychiatry and Pyschology, Mayo Clinic Health System, 221 Whipple St., Eau Claire, US
| | | | - Pamela Sinicrope
- Behavioral Health Research Program, Psychology, Mayo Clinic, Rochester, US
| | - Tabetha A Brockman
- Behavioral Health Research Program, Psychology, Mayo Clinic, Rochester, US
| | - Nicole M Reinicke
- Behavioral Health Research Program, Psychology, Mayo Clinic, Rochester, US
| | - Ian W West
- Behavioral Health Research Program, Psychology, Mayo Clinic, Rochester, US
| | - Liana M Wiepert
- Behavioral Health Research Program, Psychology, Mayo Clinic, Rochester, US
| | - Amy E Glasgow
- Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, US
| | | | - Ashley L Holland
- Department of Psychiatry and Psychology, Mayo Clinic Health System, Eau Claire, US
| | | |
Collapse
|
92
|
Tossaint-Schoenmakers R, Kasteleyn MJ, Rauwerdink A, Chavannes N, Willems S, Talboom-Kamp EPWA. Development of a quality management model and self-assessment questionnaire for hybrid health care: a concept mapping study (Preprint). JMIR Form Res 2022; 6:e38683. [PMID: 35797097 PMCID: PMC9305399 DOI: 10.2196/38683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 06/01/2022] [Accepted: 06/07/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Rosian Tossaint-Schoenmakers
- Saltro Diagnostic Centre, Unilabs Netherlands, Utrecht, Netherlands
- National eHealth Living Lab, Leiden University Medical Centre, Leiden, Netherlands
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
| | - Marise J Kasteleyn
- National eHealth Living Lab, Leiden University Medical Centre, Leiden, Netherlands
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
| | - Anneloek Rauwerdink
- Department of Surgery, Gastroenterology and Metabolism, Amsterdam University Medical Centre, Amsterdam, Netherlands
| | - Niels Chavannes
- National eHealth Living Lab, Leiden University Medical Centre, Leiden, Netherlands
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
| | - Sofie Willems
- National eHealth Living Lab, Leiden University Medical Centre, Leiden, Netherlands
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
| | - Esther P W A Talboom-Kamp
- National eHealth Living Lab, Leiden University Medical Centre, Leiden, Netherlands
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
- Unilabs Group, Geneve, Switzerland
| |
Collapse
|
93
|
Ludin N, Holt-Quick C, Hopkins S, Stasiak K, Hetrick S, Warren J, Cargo T. A chatbot to support New Zealand young people during the COVID-19 pandemic: Evaluation of a real world roll out of an open trial (Preprint). J Med Internet Res 2022; 24:e38743. [PMID: 36219754 PMCID: PMC9640203 DOI: 10.2196/38743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 07/11/2022] [Accepted: 08/18/2022] [Indexed: 12/04/2022] Open
Abstract
Background The number of young people in New Zealand (Aotearoa) who experience mental health challenges is increasing. As those in Aotearoa went into the initial COVID-19 lockdown, an ongoing digital mental health project was adapted and underwent rapid content authoring to create the Aroha chatbot. This dynamic digital support was designed with and for young people to help manage pandemic-related worry. Objective Aroha was developed to provide practical evidence-based tools for anxiety management using cognitive behavioral therapy and positive psychology. The chatbot included practical ideas to maintain social and cultural connection, and to stay active and well. Methods Stay-at-home orders under Aotearoa’s lockdown commenced on March 20, 2020. By leveraging previously developed chatbot technology and broader existing online trial infrastructure, the Aroha chatbot was launched promptly on April 7, 2020. Dissemination of the chatbot for an open trial was via a URL, and feedback on the experience of the lockdown and the experience of Aroha was gathered via online questionnaires and a focus group, and from community members. Results In the 2 weeks following the launch of the chatbot, there were 393 registrations, and 238 users logged into the chatbot, of whom 127 were in the target age range (13-24 years). Feedback guided iterative and responsive content authoring to suit the dynamic situation and motivated engineering to dynamically detect and react to a range of conversational intents. Conclusions The experience of the implementation of the Aroha chatbot highlights the feasibility of providing timely event-specific digital mental health support and the technology requirements for a flexible and enabling chatbot architectural framework.
Collapse
Affiliation(s)
- Nicola Ludin
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| | - Chester Holt-Quick
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
- School of Computer Science, The University of Auckland, Auckland, New Zealand
| | - Sarah Hopkins
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| | - Karolina Stasiak
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| | - Sarah Hetrick
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Jim Warren
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
- School of Computer Science, The University of Auckland, Auckland, New Zealand
| | - Tania Cargo
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| |
Collapse
|
94
|
Klemme I, Wrona KJ, de Jong IM, Dockweiler C, Aschentrup L, Albrecht J. Integration of people with diabetes’ vision in the development process to improve self-management via diabetes Apps: A qualitative study (Preprint). JMIR Diabetes 2022; 8:e38474. [PMID: 37104003 PMCID: PMC10176130 DOI: 10.2196/38474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 09/29/2022] [Accepted: 02/27/2023] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND Diabetes is a major global epidemic and serious public health problem. Diabetes self-management is a 24/7 challenge for people with type 1 diabetes that influences their quality of life (QoL). Certain apps can support the self-management of people with diabetes; however, current apps do not meet the needs of people with diabetes appropriately, and their safety is not ensured. Moreover, there are a multitude of hardware and software problems associated with diabetes apps and regulations. Clear guidelines are required to regulate medical care via apps. In Germany, apps must undergo 2 examination processes to be listed in the Digitale Gesundheitsanwendungen directory. However, neither examination process considers whether the medical use of the apps is sufficient for users' self-management. OBJECTIVE This study aims to contribute to the technology development process of diabetes apps by exploring individual perspectives on desired features and content of diabetes apps among people with diabetes. The vision assessment conducted is a first step toward creating a shared vision among all relevant stakeholders. To ensure adequate research and development processes for diabetes apps in the future, guiding visions from all relevant stakeholders are required. METHODS In a qualitative study, 24 semistructured interviews with patients with type 1 diabetes were conducted, among whom 10 (42%) were currently using an app. To clarify the perceptions of people with diabetes regarding the functions and content of diabetes apps, a vision assessment was conducted. RESULTS People with diabetes have concrete ideas of features and content in apps to improve their QoL and allow them to live as comfortably as possible, such as informative predictions through artificial intelligence, improvements in signal loss and value delay through smartwatches, improved communication and information-sharing capabilities, reliable information sources, and user-friendly and discreet messaging options through smartwatches. In addition, according to people with diabetes, future apps should show improved sensors and app connectivity to avoid incorrect values being displayed. They also wish for an explicit indication that displayed values are delayed. In addition, personalized information was found to be lacking in apps. CONCLUSIONS People with type 1 diabetes want future apps to improve their self-management and QoL and reduce stigma. Desired key features include personalized artificial intelligence predictions of blood glucose levels, improved communication and information sharing through chat and forum options, comprehensive information resources, and smartwatch alerts. A vision assessment is the first step in creating a shared vision among stakeholders to responsibly guide the development of diabetes apps. Relevant stakeholders include patient organizations, health care professionals, insurers, policy makers, device manufacturers, app developers, researchers, medical ethicists, and data security experts. After the research and development process, new apps must be launched while considering regulations regarding data security, liability, and reimbursement.
Collapse
Affiliation(s)
- Isabel Klemme
- School of Public Health, Bielefeld University, Bielefeld, Germany
- Athena Institute, VU University Amsterdam, Amsterdam, Netherlands
| | - Kamil J Wrona
- Faculty of Engineering and Mathematics, Bielefeld University of Applied Sciences, Bielefeld, Germany
- Faculty of Health, Bielefeld University of Applied Sciences, Bielefeld, Germany
| | | | - Christoph Dockweiler
- Department Digital Health Sciences and Biomedicine, School of Life Sciences, University of Siegen, Siegen, Germany
| | - Leona Aschentrup
- School of Public Health, Bielefeld University, Bielefeld, Germany
- Faculty of Engineering and Mathematics, Bielefeld University of Applied Sciences, Bielefeld, Germany
- Faculty of Health, Bielefeld University of Applied Sciences, Bielefeld, Germany
| | - Joanna Albrecht
- School of Public Health, Bielefeld University, Bielefeld, Germany
- Department Digital Health Sciences and Biomedicine, School of Life Sciences, University of Siegen, Siegen, Germany
| |
Collapse
|
95
|
Bello-Manga H, Haliru L, Ahmed KA, Tabari AM, Farouk BU, Bahago GY, Kazaure AS, Muhammad AS, Gwarzo SA, Baumann AA, DeBaun MR, King AA. Primary Prevention of Stroke in Children with Sickle Cell Anemia in Nigeria: Protocol for a Mixed-Methods Implementation Study in a Community Hospital (Preprint). JMIR Res Protoc 2022; 11:e37927. [PMID: 35700018 PMCID: PMC9496111 DOI: 10.2196/37927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/15/2022] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Halima Bello-Manga
- Department of Hematology and Blood Transfusion, Barau Dikko Teaching Hospital/Kaduna State University, Kaduna, Nigeria
| | - Lawal Haliru
- Department of Pediatrics, Barau Dikko Teaching Hospital/Kaduna State University, Kaduna, Nigeria
| | - Kudrat Abdulkareem Ahmed
- Department of Pediatrics, Barau Dikko Teaching Hospital/Kaduna State University, Kaduna, Nigeria
| | - Abdulkadir Musa Tabari
- Department of Radiology, Barau Dikko Teaching Hospital/Kaduna State University, Kaduna, Nigeria
| | - Bilkisu Usman Farouk
- Department of Radiology, Barau Dikko Teaching Hospital/Kaduna State University, Kaduna, Nigeria
| | - Gloria Yimi Bahago
- Department of Nursing Services, Haematology Unit, Barau Dikko Teaching Hospital, Kaduna, Nigeria
| | - Aisha Shuaibu Kazaure
- Department of Pharmaceutical Services, Barau Dikko Teaching Hopsital, Kaduna, Nigeria
| | | | | | - Ana A Baumann
- Department of Surgery, Washington University in St. Louis, St. Louis, MO, United States
| | - Michael R DeBaun
- Department of Pediatrics, Division of Pediatric Neurology, Vanderbilt University School of Medicine, Nashville, TN, United States
| | - Allison A King
- Program in Occupational Therapy, Department of Medicine, Pediatrics, Surgery, and Education, Washington University School of Medicine, St. Louis, MO, United States
| |
Collapse
|
96
|
Moreno JP, Dadabhoy H, Musaad S, Baranowski T, Thompson D, Alfano CA, Crowley SJ. Evaluation of Circadian Rhythm and Sleep Focused mHealth Intervention for the Prevention of Accelerated Summer Weight Gain among Elementary School-Age Children: Protocol for a Randomized Controlled Feasibility Study (Preprint). JMIR Res Protoc 2022; 11:e37002. [PMID: 35576573 PMCID: PMC9152728 DOI: 10.2196/37002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 03/28/2022] [Accepted: 03/29/2022] [Indexed: 11/13/2022] Open
Abstract
Background The i♥rhythm project is a mobile health adaptation of interpersonal and social rhythm therapy designed to promote healthy sleep and behavioral rhythms among 5-8-year olds during summer for the prevention of accelerated summer weight gain. Objective This pilot study will examine the feasibility, acceptability, and preliminary efficacy of the i♥rhythm intervention. This will ensure that the research protocol and procedures work as desired and are acceptable to families in preparation for the fully powered randomized controlled trial. The proposed study will examine the willingness of participants to participate in the intervention and determine whether modifications to the intervention, procedures, and measures are needed before conducting a fully powered study. We will assess our ability to (1) recruit, consent, and retain participants; (2) deliver the intervention; (3) implement the study and assessment procedures; (4) assess the reliability of the proposed measures; and (5) assess the acceptability of the intervention and assessment protocol. Methods This study will employ a single-blinded 2-group randomized control design (treatment and no-treatment control) with randomization occurring after baseline (Time 0) and 3 additional evaluation periods (postintervention [Time 1], and 9 months [Time 2] and 12 months after intervention [Time 3]). A sample of 40 parent-child dyads will be recruited. Results This study was approved by the institutional review board of Baylor College of Medicine (H-47369). Recruitment began in March 2021. As of March 2022, data collection and recruitment are ongoing. Conclusions This study will address the role of sleep and circadian rhythms in the prevention of accelerated summer weight gain and assess the intervention’s effects on the long-term prevention of child obesity. Trial Registration ClinicalTrials.gov NCT04445740; https://clinicaltrials.gov/ct2/show/NCT04445740. International Registered Report Identifier (IRRID) DERR1-10.2196/37002
Collapse
Affiliation(s)
- Jennette P Moreno
- Children's Nutrition Research Center, Department of Pediatrics-Nutrition, Baylor College of Medicine, Houston, TX, United States
| | - Hafza Dadabhoy
- Children's Nutrition Research Center, Department of Pediatrics-Nutrition, Baylor College of Medicine, Houston, TX, United States
| | - Salma Musaad
- Children's Nutrition Research Center, Department of Pediatrics-Nutrition, Baylor College of Medicine, Houston, TX, United States
| | - Tom Baranowski
- Children's Nutrition Research Center, Department of Pediatrics-Nutrition, Baylor College of Medicine, Houston, TX, United States
| | - Debbe Thompson
- Children's Nutrition Research Center, Department of Pediatrics-Nutrition, Baylor College of Medicine, Houston, TX, United States
| | - Candice A Alfano
- Sleep and Anxiety Center of Houston, Department of Psychology, University of Houston, Houston, TX, United States
| | - Stephanie J Crowley
- Biological Rhythms Research Laboratory, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
| |
Collapse
|
97
|
Gao Y, Chen X, Zhang W, Wang Q, Liu J, Zhou L. The Use of Online Ethnography for People with Chronic Conditions: A scoping review (Preprint). J Med Internet Res 2022; 24:e37941. [DOI: 10.2196/37941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 09/05/2022] [Accepted: 11/01/2022] [Indexed: 11/06/2022] Open
|
98
|
Dekkers T, Heirbaut T, Schouten SE, Kelders SM, Beerlage-de Jong N, Ludden GDS, Deenik J, Bouman YHA, Kip H. A mobile self-control training app to improve self-control and physical activity in people with severe mental illness: Protocol for two single-case experiment designs (Preprint). JMIR Res Protoc 2022; 12:e37727. [PMID: 37145845 DOI: 10.2196/37727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 02/23/2023] [Accepted: 02/25/2023] [Indexed: 02/27/2023] Open
Abstract
BACKGROUND Lack of physical activity is a common issue with detrimental consequences for the health of people with severe mental illness (SMI). Existing physical activity interventions show suboptimal effects as they require substantial cognitive skills, including goal setting and writing, whereas cognitive deficits are common in this population. To bolster the effectiveness of physical activity interventions, self-control training (SCT), in which users practice the ability to override unwanted thoughts and behaviors, can be used in addition. Recent research has demonstrated the initial effectiveness of a mobile SCT app, but this has not been studied in psychiatric clinical practice. OBJECTIVE This study aims to evaluate to what extent adding a mobile SCT app designed for and with people with SMI to a mobile lifestyle intervention aimed at increasing physical activity increases physical activity and self-control levels. METHODS A mixed methods approach incorporating 2 single-case experimental designs (SCEDs) and qualitative interviews was used to evaluate and optimize SCT. Overall, 12 participants with SMI will be recruited from 2 organizations offering outpatient and inpatient care to people with SMI. Each experiment will include 6 patients. SCED I is a concurrent multiple-baseline design across participants that explores initial effectiveness and optimal intervention duration. Using accelerometry and experience sampling questionnaires, participants' physical activity and self-control will be monitored for ≥5 days from baseline, followed by the sequential introduction of Google Fit, the physical activity intervention, for 7 days and the addition of SCIPP: Self-Control Intervention App for 28 days. SCED II is an introduction/withdrawal design in which optimized SCT will be introduced and withdrawn to validate the findings from SCED I. In both experiments, the daily average of total activity counts per hour and the state level of self-control will serve as the primary and secondary outcome measures. Data will be analyzed using visual analysis and piecewise linear regression models. RESULTS The study was designated as not subject to the Dutch Medical Research Involving Human Subjects Act by the Medical Research Ethical Committee Oost-Nederland and approved by the Ethics Committee/domain Humanities and Social Sciences of the Faculty of Behavioural, Management, and Social Sciences at the University of Twente. Participant recruitment started in January 2022, and we expect to publish the results in early 2023. CONCLUSIONS The mobile SCT app is expected to be feasible and effective. It is self-paced and scalable and can increase patient motivation, making it a suitable intervention for people with SMI. SCED is a relatively novel yet promising method for gaining insights into whether and how mobile apps work that can handle heterogeneous samples and makes it possible to involve a diverse population with SMI without having to include a large number of participants. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/37727.
Collapse
Affiliation(s)
- Tessa Dekkers
- Centre for eHealth and Wellbeing Research, Department of Technology, Human and Institutional Behaviour, University of Twente, Enschede, Netherlands
| | - Tahnee Heirbaut
- Centre for eHealth and Wellbeing Research, Department of Technology, Human and Institutional Behaviour, University of Twente, Enschede, Netherlands
| | - Stephanie E Schouten
- Centre for eHealth and Wellbeing Research, Department of Technology, Human and Institutional Behaviour, University of Twente, Enschede, Netherlands
| | - Saskia M Kelders
- Centre for eHealth and Wellbeing Research, Department of Technology, Human and Institutional Behaviour, University of Twente, Enschede, Netherlands
- Optentia Research Unit, North-West University, Vanderbijlpark, South Africa
| | - Nienke Beerlage-de Jong
- Technical Medical Centre, Section of Health Technology and Services Research, University of Twente, Enschede, Netherlands
| | - Geke D S Ludden
- Department of Design Production & Management, Faculty of Engineering Technology, University of Twente, Enschede, Netherlands
| | - Jeroen Deenik
- GGz Centraal, Amersfoort, Netherlands
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
| | | | - Hanneke Kip
- Centre for eHealth and Wellbeing Research, Department of Technology, Human and Institutional Behaviour, University of Twente, Enschede, Netherlands
- Department of Research, Stichting Transfore, Deventer, Netherlands
| |
Collapse
|
99
|
Tahsin F, Austin T, McKinstry B, Mercer SW, Mayura L, Thavorn K, Upshur R, Steele Gray C. Examining usage behavior of a goal-supporting mHealth app in primary care among patients with multiple chronic conditions: A qualitative study (Preprint). JMIR Hum Factors 2022; 9:e37684. [DOI: 10.2196/37684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 09/13/2022] [Accepted: 10/06/2022] [Indexed: 11/06/2022] Open
|
100
|
Pasquini S, Margaritini A, Gambella E, Di Rosa M, Maranesi E, Bevilacqua R, Civerchia P, Pelliccioni G. A psychosocial intervention for supporting the informal caregivers of older people with Alzheimer’s disease: The “INNfamiglia” study protocol (Preprint). JMIR Res Protoc 2022; 11:e37496. [DOI: 10.2196/37496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 07/14/2022] [Accepted: 09/12/2022] [Indexed: 11/13/2022] Open
|