Men's sociotechnical imaginaries of artificial intelligence for prostate cancer diagnostics - A focus group study

Artificial intelligence (AI) is increasingly used for diagnostic purposes in cancer care. Prostate cancer is one of the most prevalent cancers affecting men worldwide, but current diagnostic approaches have limitations in terms of specificity and sensitivity. Using AI to interpret MR images in prostate cancer diagnostics shows promising results, but raises questions about implementation, user acceptance, trust, and doctor-patient communication. Drawing on approaches from the sociology of expectations and theories about sociotechnical imaginaries, we explore men's expectations of artificial intelligence for prostate cancer diagnostics. We conducted ten focus groups with 48 men aged 54-85 in Norway with various experiences of prostate cancer diagnostics. Five groups of men had been treated for prostate cancer, one group was on active surveillance, two groups had been through prostate cancer diagnostics without having a diagnosis, and two groups of men had no experience with prostate cancer diagnostics or treatment. Data was subject to reflexive thematic analysis. Our analysis suggests that men's expectations of AI for prostate cancer diagnostics come from two perspectives: Technology-centered expectations that build on their conceptions of AI's form and agency, and human-centered expectations of AI that build on their perceptions of patient-professional relationships and decision-making processes. These two perspectives are intertwined in three imaginaries of AI: The tool imaginary, the advanced machine imaginary, and the intelligence imaginary - each carrying distinct expectations and ideas of technologies and humans' role in decision-making processes. These expectations are multifaceted and simultaneously optimistic and pessimistic; while AI is expected to improve the accuracy of cancer diagnoses and facilitate more personalized medicine, AI is also expected to threaten interpersonal and communicational relationships between patients and healthcare professionals, and the maintenance of trust in these relationships. This emphasizes how AI cannot be implemented without caution about maintaining human healthcare relationships.

Types of Offers of Combustible Cigarettes, E-Cigarettes, and Betel Nut Experienced by Guam Youths

The present study examined types of scenarios in which Guam youths are offered tobacco-namely, combustible cigarettes and e-cigarettes-and betel (areca) nut. We conducted 10 focus groups with public middle school students (n = 34) from Guam. Results suggested that the types of offer scenarios of combustible cigarettes, e-cigarettes, and betel nut referenced by the students fall into two categories-direct-relational offers and indirect-contextual offers. The results also suggested that both categories of offer scenarios were more likely to occur in school rather than in other locations such as the home. Family members were more likely to make offers than other types of people. Indirect-contextual offers were more easily avoidable depending on the substance offered, the location where the offer took place, and the person making the offer. Based on the findings, we provide brief suggestions on developing a school-based prevention curriculum focused on training young adolescents from Guam on ways to resist offers of cigarettes, e-cigarettes, and betel nut.

Using Web-Based Content to Connect Young People With Real-life Mental Health Support: Qualitative Interview Study

BACKGROUND

Young people experience high rates of mental health problems but make insufficient use of the formal services available to them. As young people are heavy users of the internet, there may be an untapped potential to use web-based content to encourage this hard-to-reach population to make better use of face-to-face mental health services. However, owing to the vast range of content available and the complexities in how young people engage with it, it is difficult to know what web-based content is most likely to resonate with this age group and facilitate their engagement with professional support.

OBJECTIVE

This study aimed to identify the types of web-based content young people identified as more likely to prompt youth engagement with mental health services.

METHODS

This study used a qualitative design conducted within a social constructionist epistemology that recognized the importance of youth empowerment in mental health. Digital interviews using WhatsApp instant messenger were conducted with 37 young people aged 16-23 years who participated as "expert informants" on the priorities and practices of youth in web-based spaces. The data were analyzed using reflexive thematic analysis to identify the types of web-based content that participants believed would encourage young people to reach out to a face-to-face mental health service for support.

RESULTS

The analysis generated 3 main themes related to the research question. First, participants noted that a lack of information about available services and how they worked prevented young people from engaging with face-to-face mental health services. They proposed web-based content that provided clear information about relevant mental health services and how to access them. They also suggested the use of both text and video to provide young people with greater insight into how face-to-face counseling might work. Second, participants recommended content dedicated to combating misconceptions about mental health and negative portrayals of mental health services and professionals that are prevalent in their web-based spaces. They suggested content that challenged the stigma surrounding mental health and help seeking and highlighted the value of mental health services. Finally, participants suggested that young people would be more likely to respond to "relatable" digital stories of using mental health services, recounted in the context of a personal connection with someone they trusted.

CONCLUSIONS

This study offers recommendations for professionals and service providers on how to better engage young people with real-life mental health support using web-based content. Web-based content can be used to challenge some of the barriers that continue to prevent young people from accessing face-to-face mental health services and underlines the importance of including young people's voices in the design of web-based mental health content.

Motivating playgrounds: understanding how school playgrounds support autonomy, competence, and relatedness of tweens

Purpose

Physical activity (PA) is an important factor contributing to general health. PA declines rapidly during tween years (9–12 years) when children’s social world changes. School playgrounds can contribute substantially to children’s PA, but little is known about how to motivate tweens to use school playgrounds. Using the three basic psychological needs (autonomy, competence, and relatedness) proposed by the Self-Determination Theory, this qualitative study aimed to investigate how school playgrounds can support tweens’ needs.

Methods

Tweens (n = 56) participated in focus group go-along interviews in their school playground.

Results

We found that tweens needed a variety of play possibilities (autonomy) that challenged their skills (competence) as well as areas to retract and be with friends (relatedness).

Conclusion

This research highlights the importance of incorporating tweens’ perspectives in playground design to attract and retain them in play and PA in school playgrounds.

Health-Related Quality of Life after Pediatric Traumatic Brain Injury: A Qualitative Comparison of Perspectives of Children and Adolescents after TBI and a Comparison Group without a History of TBI

BACKGROUND

The assessment of the impact of pediatric traumatic brain injury (TBI) on the health-related quality of life (HRQoL) of the children and adolescents affected can be ameliorated by a disease-specific instrument. Such an instrument does not yet exist. This qualitative study investigates how children and adolescents after TBI subjectively perceive their HRQoL and whether and how this differs from the perspective of individuals without a history of TBI.

METHODS

Eight problem-centered interviews were conducted with 11 children and adolescents around four years after mild TBI and with eight children and adolescents around three years after moderate to severe TBI. Nine problem-centered interviews were conducted with 25 participants without a history of TBI. The interviews were recorded and transcribed verbatim. The statements were assigned to inductively and deductively derived categories relevant to the HRQoL of children and adolescents after TBI and compared with those of individuals without a history of TBI.

RESULTS

The HRQoL of children and adolescents after TBI tended to display both structural and content-related differences, independently of TBI severity, on several HRQoL dimensions, in contrast to the comparison group. For example, participants after TBI reported a broader range of negative emotions (such as worry, sadness, shame, and guilt), permanent physical impairments, felt that they were treated differently from others, and perceived cognitive limitations.

CONCLUSIONS

The results of this qualitative study identified HRQoL dimensions that are relevant to children and adolescents after TBI and underlined the need for the development of a disease-specific instrument.

Adolescents' experiences of a theory-based behavioural intervention for improved oral hygiene: A qualitative interview study

OBJECTIVES

Adequate oral hygiene, that is self-performed infection control, is crucial to prevent periodontal disease. Epidemiological studies reveal poor oral hygiene conditions among Swedish adolescents and indicate a need for more effective prevention programs. The aim of the current study was to analyse adolescents' experiences of a person-centred, theory-based, oral health education program for improved oral hygiene.

METHODS

Data were obtained by interviewing 19 adolescents treated by dental hygienists in accord with the person-centred education program in a preceding clinical field study (ClinicalTrials.gov NCT02906098). Study participants were selected to reflect a variation of male and female adolescents, treated at clinics in areas with various socio-demographic profiles within Region Västra Götaland, Sweden. Interviews were audio-taped, transcribed verbatim and analysed with qualitative content analysis.

RESULTS

A main theme was identified: 'Adolescents on a guided and challenging journey towards beneficial oral hygiene behavior'. The results elucidate the importance of a person-centred approach in therapy. The adolescents described insight on a personal level about the importance of improved oral hygiene as fundamental for behavioural change. Planning and monitoring of the behaviour, with guidance and support by the dental hygienist, was considered to facilitate change and encouraged further behavioural efforts. However, the adolescents expressed a need of reminders and support to keep up oral hygiene routines over time.

CONCLUSIONS

The study brings knowledge on factors of importance in educational interventions to increase beneficial health behaviours among adolescents and emphasize areas for further improvements of such interventions.

Adolescents' Perceptions of Gender Aspects in a Virtual-Reality-Based Alcohol-Prevention Tool: A Focus Group Study

Virtual reality (VR) is an innovative tool for alcohol prevention among adolescents. However, many aspects of virtual simulations for alcohol prevention remained unstudied, and research on opportunities for tailoring such tools to users’ gender using avatar-based pathways is lacking. The present study, therefore, explores adolescents’ perceptions of gender portrayal and gender tailoring using Virtual LimitLab—a VR simulation for building refusal skills for dealing with peer pressure to consume alcohol. Focus groups were conducted after individual simulation testing with 13 adolescents in four groups, whose statements and discussion underwent thematic analysis. Three main themes were identified: the relevance of gender, opinions on different tailoring options for gender, and opinions on flirt orientation. Divergent arguments for different tailoring options and representations of gender in the simulation were proposed. Some participants changed opinions during discussions. Sexual harassment was consensually deemed an important issue that is linked to both partying and alcohol and was concluded to require being addressed along with alcohol prevention. A consensus also formed around open flirting possibilities (regardless of gender), and awareness of non-binary peers was raised. Based on the observed sensitivity of the adolescents to gender diversity, it is necessary to include LGBTQIA+ adolescents when developing gender-sensitive simulations.

Sociocultural Influences on Exercise Behaviors and Attitudes in Adolescence

BACKGROUND

Research to date has identified a relationship between exercise in adolescence and 4 sociocultural influences: peers, family, media, and technology. Less is known, however, about the role that these sociocultural influences play in driving adolescents' exercise behaviors and attitudes, particularly social media and fitness tracking technology use. This study aimed to investigate how and why sociocultural factors are linked to exercise behaviors and attitudes in adolescent boys and girls.

METHODS

Eight focus groups were conducted in UK secondary schools with fifty-five 12- to 16-year-old adolescents (M = 14.11; SD = 1.49; n = 27 females). Following transcription and thematic analysis, 2 key themes were identified: (1) exercise pressures and (2) modeling exercise behaviors and attitudes.

RESULTS

Exercise pressures were reported to stem from parental and peer expectations around exercise, and from feeling pressure to meet externally prescribed fitness tracking technology goals. Adolescents also reported modeling the exercise behaviors of their parents or peers for social affiliation and as a means to achieve socially endorsed "ideal" body types.

CONCLUSIONS

These findings highlight the need for exercise interventions to consider the importance of exercise-related messages from others and tendencies toward conformity as a result of sociocultural expectations around exercise in adolescents.

Text Messages and Financial Incentives to Increase Physical Activity in Adolescents With Prediabetes and Type 2 Diabetes: Web-Based Group Interviews to Inform Intervention Design

BACKGROUND

Physical activity is a major component of treatment for adolescents with obesity and prediabetes or type 2 diabetes; however, sedentary behavior remains pervasive. An SMS text message-based intervention paired with financial incentives may be an effective way to promote physical activity in this population.

OBJECTIVE

This study aims to obtain end-user feedback on SMS text message content and assess the acceptability of a planned SMS text messaging intervention with financial incentives to motivate youth with prediabetes or type 2 diabetes to increase physical activity.

METHODS

Adolescents with overweight or obesity and prediabetes or type 2 diabetes who attended a large academic pediatric endocrinology clinic were recruited to participate in group interviews (2-4/group) via videoconferencing. Participants were asked to share their thoughts on the use of SMS text messages and financial incentives to remind and motivate them to be more physically active. They rated and provided feedback on specific messages to be used in clinical trials. Participants were also asked about their personal experience with rewards to motivate behavior change and their anticipated reactions to rewards provided for goal attainment (gain-framing) versus those provided and then taken away if a goal was not met (loss-framing). The interviews were conducted by 2 trained interviewers and a note-taker. Content analysis was used to explore themes.

RESULTS

Group interviews were completed with 20 participants (11/20, 55% women; 15/20, 75% with type 2 diabetes; 5/20, 25% with prediabetes) with a mean age of 15 (SD 1; range 12-18) years and a mean BMI of 41 (SD 5) kg/m² (all >95th percentile for age and sex). Most participants were non-Hispanic Black (14/20, 70%) and 10% (2/20) were Hispanics. Participants frequently cited near-continuous smartphone use and agreed that SMS text messages would serve as good reminders to be physically active, but the consensus about the need for short messages was strong. Favorable content included references to what they were likely to be doing when messages were sent (eg, homework or watching television) and messages that were upbeat or informative. Specific physical activity suggestions were rated favorably. Attitudes toward financial incentives varied, with differing opinions about whether loss-framed incentives would be motivating or discouraging. Many participants highlighted the role of intrinsic, rather than extrinsic, motivation in achieving and sustaining behavior change.

CONCLUSIONS

The engagement of adolescents with obesity and diabetes or prediabetes allowed for the refinement of SMS text messages for our planned intervention, with an emphasis on short, upbeat, relatable, and informative messages. Although an SMS text messaging intervention using financial incentives to motivate youth with prediabetes or type 2 diabetes to be more physically active is theoretically acceptable, the impact on actual activity levels in this population requires prospective evaluation in a clinical trial.

COVID-19 conversations: A qualitative study of majority Hispanic/Latinx youth experiences during early stages of the pandemic

Background

Growing evidence informs about the detrimental impact that COVID-19 has had on youths' mental health and well-being. As of yet, no study has directly examined the experiences and perspectives of children and young adolescents from racial and ethnic minority groups in the U.S., despite being exposed to more adversity, which may affect coping with the many challenges posed by the pandemic.

Objective

This study aimed to give voice to a mostly Hispanic/Latinx group of youth regarding the impact of COVID-19 stay-at-home measures and to identify their emotional responses and coping strategies amid the pandemic in the U.S. when restrictions were at their hardest.

Method

A total of 17 youths (70.6 % Hispanic; age range = 10-14 years; 52.9 % female) participated in four virtual semi-structured focus groups for each grade level (grades 5-8). Data was transcribed and analyzed using a gold standard thematic analysis approach.

Results

Seven themes were identified concerning the impact of COVID-19, centering around the impact of racism, loss of income, the role of community and family in coping with stress, information overload, home-schooling, loneliness and boredom, and lack of structured routines.

Conclusions

Our findings suggest that cultural factors (e.g., collectivism and familism) in Hispanic communities may offer important buffering during COVID-19. Future research studies evaluating the implementation of structured programs that provide a space to talk about emotions and thoughts related to the impact of the pandemic and training in strategies to cope with distress during mandatory home-schooling are needed.

Cultural Stress in the Age of Mass Xenophobia: Perspectives from Latin/o Adolescents

During the last four years, xenophobic rhetoric directed toward Latino immigrants in U.S. media outlets and political forums has greatly increased. Using a general inductive approach, this qualitative study examined the forms of cultural stress, with a focus on discrimination and xenophobia, experienced by Latino adolescents in urban U.S. settings in 2018 and 2019. Six focus groups were conducted in Miami and Los Angeles (three groups per city) with first- and second-generation tenth-grade Latino students (n = 34). The following four themes emerged from the data: perceived discrimination from other Latino subgroups (in-group discrimination), perceived discrimination from non-Latino groups (out-group discrimination), internalization of stressors and discrimination experienced by participants' parents, and the current U.S. political rhetoric surrounding immigration. Understanding cultural stress among Latino adolescents provides valuable insight for future interventions to offset negative health outcomes associated with cultural stress.

Schools as Sites for Recruiting Participants and Implementing Research

Schools can be a valuable resource for recruitment of participants for research involving children, adolescents, and parents. Awareness of the benefits and challenges of working with schools can assist researchers in developing effective school partnerships. This article discusses the advantages of conducting research within the school system as well as the challenges that may also arise. Such challenges include developing key contacts, building relationships, logistical arrangements, and facilitating trust in the research topic and team. Suggestions for strategies to forge successful collaborative relationships with schools are provided.

Determinants of tobacco-related health literacy: A qualitative study with early adolescents

BACKGROUND

Today's adolescents are used to a constant information flow, but many face difficulties in processing health-related information due to low health literacy. There is still need for deeper understanding on the determinants of health literacy in relation to adolescents to guide the development of health literacy instruments and interventions.

PURPOSE

The purpose of this study was to explore, from the perspective of early adolescents, the determinants of health literacy in the context of tobacco-related health communication.

DESIGN

A qualitative descriptive study.

SETTING

Two schools located in the south of Finland. One school represented a typical Finnish public school with students following general curriculum and the other represented a Finnish public school with students with special educational needs.

PARTICIPANTS

Purposively selected sample of 10-13-year-old early adolescents (n=39) from the two schools to obtain a varied group of early adolescents representing different kinds of literacy levels.

METHODS

We conducted 10 focus groups with early adolescents and analyzed the data using the theoretical thematic analysis method. We used a combination of the determinants presented in three adolescent-specific health literacy models as the theoretical framework of deductive analysis. The remaining data extracts were coded inductively. We sorted the codes under sub-themes that represented different determinants of health literacy. These were further divided between three themes: "personal", "external", and "mediating" determinants. Finally, we named the themes with an expression that embodied the early adolescents' views and experiences.

RESULTS

Early adolescents' descriptions revealed that the list of determinants presented in the three adolescent-specific health literacy models is not comprehensive enough. Early adolescents brought up how their motives, self-efficacy, and role expectations determine their health literacy in addition to the other personal determinants presented in the previous models. Their descriptions also suggest that external determinants include interpersonal relations with authorities, idols and random people, and the socio-cultural atmosphere as new factors. New mediating determinants that have a separate influence on health literacy were recognized based on early adolescents' descriptions as well.

CONCLUSION

Our findings give a new, adolescent-oriented insight on the determinants of adolescents' health literacy. Based on the findings, there are additional personal, external, and mediating determinants that are not included in the current adolescent-specific health literacy models. These newly found determinants require attention and further exploration. The acquired knowledge can be used for strengthening existing adolescent-specific health literacy models, and as a basis of health literacy instrument and intervention development.

High School Youth's Reactions to Participating in Mixed-Methodological Dating Violence Research

The present study used a sample of high school youth (N = 218) and a mixed-methodological research design to examine high school students' reactions to participating in focus groups and completing surveys that inquired about dating violence (DV). Results showed that showed that 1.5% (n = 3) of the youth regretted participating in the study and 6% (n = 12) were upset by the study questions; being upset was attributed to personal experiences with DV and being disturbed by peers' responses during the focus group. Furthermore, 49% (n = 99) of the youth reported feeling that they personally benefited from participating in the study for reasons such as learning ways to help friends in situations of DV. Results have implications for conducting mixed-methodological DV research with youth.

Factors influencing adolescent whole grain intake: A theory-based qualitative study

Whole grain consumption is associated with reduced risk of chronic disease. One-fifth of UK adults and children do not consume any whole grains, and adolescents have low consumption rates. Factors affecting whole grain intake among adolescents are not well understood. This study examined the socio-economic, environmental, lifestyle and psychological factors likely to influence consumption and explored whether outcomes aligned with behavioural predictors proposed in the Reasoned Action Approach. Five focus groups explored young people's attitudes towards, knowledge and consumption of wholegrain foods, as well as barriers to, and facilitators of, consumption. Participants were male and female adolescents (n = 50) aged 11-16 years from mixed socioeconomic backgrounds and ethnicities, recruited through schools in the city of Leeds, UK. Focus groups were analysed using thematic analysis. Most participants had tried wholegrain food products, with cereal products being the most popular. Many recognised whole grain health benefits related to digestive health but not those related to heart disease or cancers. Several barriers to eating whole grains were identified including: difficulties in identifying wholegrain products and their health benefits; taste and visual appeal; and poor availability outside the home. Suggested facilitators of consumption were advertisements and educational campaigns, followed by improved sensory appeal, increased availability and choice, and tailoring products for young people. All constructs of the Theory of Reasoned Action were identifiable in the data, suggesting that the factors influencing whole grain intake in adolescents are well captured by this model. Study outcomes may inform research and health promotion to increase whole grain intake in this age group.