Validity and Reliability of the Korean Version of the Health Information Technology Usability Evaluation Scale: Psychometric Evaluation

User-centered design to enhance university students' sex and menstrual education in South Korea: randomized controlled trial

BACKGROUND

In South Korea, access to reliable and developmentally appropriate sexual and menstrual health education tailored to the specific needs of university students remains limited. This study sought to address this gap by developing and evaluating student co-designed, mobile-based educational modules focused on these crucial health topics.

METHODS

A mixed-methods design was employed to evaluate the effectiveness of the developed educational modules. Eighty unmarried university students in South Korea were randomly assigned to either a PDF group (n = 40) or a Video group (n = 40). The modules provided instruction on both sexual and menstrual health. Semi-structured interviews were conducted with participants in each group to explore their experiences with the modules.

RESULTS

The Video group showed a notable improvement in sexual health knowledge (t = -2.657, p =.010) following the intervention. Similarly, the PDF group exhibited a statistically significant increase in menstrual health knowledge (t = -2.608, p =.011) compared to their pre-intervention knowledge levels. However, the total quiz scores of the PDF group were significantly higher than those of the Video group (t = 2.69, p =.009). Qualitative analysis revealed that participants in both groups perceived video-based education as more effective than the PDF.

CONCLUSION

While overall knowledge gain didn't significantly differ between groups (except for quiz results), the findings offer valuable insights for developing mobile-based sexual and menstrual health education. Qualitative data suggests a preference for video learning, informing future module development. Further research should explore optimal format and content for maximizing intervention impact.

TRIAL REGISTRATION

This trial was registered in a Clinical Research Information Service in Korea linked with the World Health Organization's International Clinical Trial Registry Platform (WHO's ICTRP) (30/11/2023, no. KCT0009006).

Feasibility of a contraceptive-specific electronic health record system to promote the adoption of pharmacist-prescribed contraceptive services in community pharmacies in the United States

Objectives

Pharmacists in over half of the United States can prescribe contraceptives; however, low pharmacist adoption has impeded the full realization of potential public health benefits. Many barriers to adoption may be addressed by leveraging an electronic health records (EHR) system with clinical decision support tools and workflow automation. We conducted a feasibility study to determine if utilizing a contraceptive-specific EHR could improve potential barriers to the implementation of pharmacist-prescribed contraceptive services.

Materials and Methods

20 pharmacists each performed two standardized patient encounter simulations: one on the EHR and one on the current standard of care paper-based workflow. A crossover study design was utilized, with each pharmacist performing encounters on both standardized patients with the modality order randomized. Encounters were timed, contraceptive outputs were recorded, and the pharmacists completed externally validated workload and usability surveys after each encounter, and a Perception, Attitude, and Satisfaction survey created by the research team after the final encounter.

Results

Pharmacists were more likely to identify contraceptive ineligibility using the EHR-based workflow compared to the paper workflow (P = .003). Contraceptive encounter time was not significantly different between the 2 modalities (P = .280). Pharmacists reported lower mental demand (P = .003) and greater perceived usefulness (P = .029) with the EHR-based workflow compared to the paper modality.

Discussion and Conclusion

Pharmacist performance and acceptance of contraceptive services delivery were improved with the EHR workflow. Pharmacist-specific contraceptive EHR workflows show potential to improve pharmacist adoption and provision of appropriate contraceptive care.

Development and Validation of a Mobile-Centered Digital Health Readiness Scale (mDiHERS): Health Literacy and Equity Scale

BACKGROUND

There has been a rapid expansion of digital health care services, making the need for measuring and improving digital health readiness a priority. In response, our study team developed the Mobile-Centered Digital Health Readiness: Health Literacy and Equity Scale (mDiHERS) to measure digital health readiness.

OBJECTIVE

We aim to develop and validate a scale that assesses digital health readiness, encompassing literacy and equity, and to ensure the effective use of mobile-centered digital health services.

METHODS

This study was conducted from October 2021 to October 2022 to develop and validate the mDiHERS. Participants included patients with inflammatory bowel disease, which is a chronic condition requiring continuous management, and experts in medical and nursing informatics. The scale development involved a literature review, focus group interviews, and content validity evaluations. A total of 440 patients with inflammatory bowel disease were recruited for the validation phase, with 403 completing the survey. The scale's validity and reliability were assessed through exploratory factor analysis and Cronbach α. The scale was translated into English by translators and bilingual and native researchers, ensuring its applicability in diverse settings.

RESULTS

The mDiHERS consists of 36 items across 6 domains, with a 5-point Likert scale for responses. The validation process confirmed the scale's construct validity, with 4 factors explaining 65.05% of the total variance. The scale's reliability was established with Cronbach α values ranging from 0.84 to 0.91. The scale's development considered the technical proficiency necessary for engaging with health mobile apps and devices, reflecting the importance of subjective confidence and objective skills in digital health literacy.

CONCLUSIONS

The mDiHERS is a validated tool for measuring patients' readiness and ability to use digital health services. The mDiHERS assesses user characteristics, digital accessibility, literacy, and equity to contribute to the effective use of digital health services and improve accessibility. The development and validation of the mDiHERS emphasize the importance of confidence and competence in managing health digitally. Continuous improvements are necessary to ensure that all patients can benefit from digital health care.

Digital Health Equity and Tailored Health Care Service for People With Disability: User-Centered Design and Usability Study

BACKGROUND

As digital health services advance, digital health equity has become a significant concern. However, people with disability and older adults still face health management limitations, particularly in the COVID-19 pandemic. An essential area of investigation is proposing a patient-centered design strategy that uses patient-generated health data (PGHD) to facilitate optimal communication with caregivers and health care service providers.

OBJECTIVE

This study aims to conceptualize, develop, and validate a digitally integrated health care service platform for people with disability, caregivers, and health care professionals, using Internet of Things devices and PGHD to contribute to improving digital health equity.

METHODS

The methodology consists of 5 stages. First, a collaborative review of the previous app, Daily Healthcare 1.0, was conducted with individuals with disabilities, caregivers, and health care professionals. Secondly, user needs were identified via personas, scenarios, and user interface sketches to shape a user-centered service design. The third stage created an enhanced app that integrated these specifications. In the fourth stage, heuristic evaluations by clinical and app experts paved the way for Daily Healthcare 2.0, now featuring Internet of Things device integration. Conclusively, in the fifth stage, an extensive 2-month usability evaluation was executed with user groups comprising individuals with disabilities using the app and their caregivers.

RESULTS

Among the participants, "disability welfare information and related institutional linkage" was the highest priority. Three of the 14 user interface sketches the participants created were related to "providing educational content." The 11 heuristic evaluation experts identified "focusing on a single task" as a crucial issue and advocated redesigning the home menu to simplify it and integrate detailed menus. Subsequently, the app Daily Healthcare 2.0 was developed, incorporating wearable devices for collecting PGHD and connecting individuals with disabilities, caregivers, and health care professionals. After the 2-month usability evaluation with 27 participants, all participants showed an increase in eHealth literacy, particularly those who used the caregiver app. Relatively older users demonstrated improved scores in health IT usability and smartphone self-efficacy. All users' satisfaction and willingness to recommend increased, although their willingness to pay decreased.

CONCLUSIONS

In this study, we underscore the significance of incorporating the distinct needs of individuals with disabilities, caregivers, and health care professionals from the design phase of a digital health care service, highlighting its potential to advance digital health equity. Our findings also elucidate the potential benefits of fostering partnerships between health consumers and providers, thereby attenuating the vulnerability of marginalized groups, even amid crises such as the COVID-19 pandemic. Emphasizing this imperative, we advocate for sustained endeavors to bolster the digital literacy of individuals with disabilities and champion collaborative cocreation, aiming to uphold the collective ethos of health and digital health equity.

Menstrual Tracking Mobile App Review by Consumers and Health Care Providers: Quality Evaluations Study

BACKGROUND

Women's menstrual cycle is an important component of their overall health. Physiological cycles and associated symptoms can be monitored continuously and used as indicators in various fields. Menstrual apps are accessible and can be used to promote overall female health. However, no study has evaluated these apps' functionality from both consumers' and health care providers' perspectives. As such, the evidence indicating whether the menstrual apps available on the market provide user satisfaction is insufficient.

OBJECTIVE

This study was performed to investigate the key content and quality of menstrual apps from the perspectives of health care providers and consumers. We also analyzed the correlations between health care provider and consumer evaluation scores. On the basis of this analysis, we offer technical and policy recommendations that could increase the usability and convenience of future app.

METHODS

We searched the Google Play Store and iOS App Store using the keywords "period" and "menstrual cycle" in English and Korean and identified relevant apps. An app that met the following inclusion criteria was selected as a research app: nonduplicate; with >10,000 reviews; last updated ≤180 days ago; relevant to this topic; written in Korean or English; available free of charge; and currently operational. App quality was evaluated by 6 consumers and 4 health care providers using Mobile Application Rating Scale (MARS) and user version of the Mobile Application Rating Scale (uMARS). We then analyzed the correlations among MARS scores, uMARS scores, star ratings, and the number of reviews.

RESULTS

Of the 34 apps, 31 (91%) apps could be used to predict the menstrual cycle, and 2 (6%) apps provided information pertinent to health screening. All apps that scored highly in the MARS evaluation offer a symptom logging function and provide the user with personalized notifications. The "Bom Calendar" app had the highest MARS (4.51) and uMARS (4.23) scores. The MARS (2.22) and uMARS (4.15) scores for the "Menstrual calendar-ovulation & pregnancy calendar" app were different. In addition, there was no relationship between MARS and uMARS scores (r=0.32; P=.06).

CONCLUSIONS

We compared consumer and health care provider ratings for menstrual apps. Continuous monitoring of app quality from consumer and health care provider perspectives is necessary to guide their development and update content.

Validation and usability study of the framework for a user needs-centered mHealth app selection

BACKGROUND

Most mHealth app users rely on an app's rankings, star ratings, or reviews, which may not reflect users' individual healthcare needs. To help healthcare providers, researchers, and users select an optimal mHealth app, the Method of App Selection based on User Needs (MASUN) 1.0¹ was developed and tested in prior research. Initial testing found the need for improvement.

OBJECTIVE

This multiple-phase study aimed to simplify and improve MASUN 1.0, resulting in MASUN 2.0, and verify the feasibility and usability of MASUN 2.0.

METHODS

This study was conducted in three phases: (1) modification of MASUN 1.0 to improve its importance, applicability, relevance, and clarity, in consultation with 21 experts in medical or nursing informatics; (2) validation of the draft MASUN 2.0, with 13 experts; and (3) feasibility testing of MASUN 2.0 and usability evaluation of the best app found through MASUN 2.0. Menstrual apps were used to test the framework.

RESULTS

From Phases 1 and 2, MASUN 2.0, the framework for mHealth App selection, was derived with improved simplicity, usability, and applicability through a reduced number of tasks and time required. In Phase 3, after screening and scoring 2377 menstrual apps, five candidate apps were selected and evaluated by five clinical experts, five app experts, and five potential users. Finally, 194 users evaluated the usability of the app selected as the best. The best app helped users understand their health-related syndromes and patterns. Additionally, user-provided scores for impact, usefulness, and ease of use for the app were higher than for others.

CONCLUSIONS

This study successfully modified MASUN 1.0 into MASUN 2.0 and verified MASUN 2.0 through content validity, feasibility, and usability testing. The selected apps through MASUN 2.0 helped health consumers more easily address health discomfort. Future research should extend this work to an automated system and different medical conditions with multiple stakeholders for digital health equity.