@Article{info:doi/10.2196/67682, author="Baek, Gumhee and Cha, Chiyoung and Han, Jin-Hui", title="AI Chatbots for Psychological Health for Health Professionals: Scoping Review", journal="JMIR Hum Factors", year="2025", month="Mar", day="19", volume="12", pages="e67682", keywords="artificial intelligence", keywords="AI chatbot", keywords="psychological health", keywords="health professionals", keywords="burnout", keywords="scoping review", abstract="Background: Health professionals face significant psychological burdens including burnout, anxiety, and depression. These can negatively impact their well-being and patient care. Traditional psychological health interventions often encounter limitations such as a lack of accessibility and privacy. Artificial intelligence (AI) chatbots are being explored as potential solutions to these challenges, offering available and immediate support. Therefore, it is necessary to systematically evaluate the characteristics and effectiveness of AI chatbots designed specifically for health professionals. Objective: This scoping review aims to evaluate the existing literature on the use of AI chatbots for psychological health support among health professionals. Methods: Following Arksey and O'Malley's framework, a comprehensive literature search was conducted across eight databases, covering studies published before 2024, including backward and forward citation tracking and manual searching from the included studies. Studies were screened for relevance based on inclusion and exclusion criteria, among 2465 studies retrieved, 10 studies met the criteria for review. Results: Among the 10 studies, six chatbots were delivered via mobile platforms, and four via web-based platforms, all enabling one-on-one interactions. Natural language processing algorithms were used in six studies and cognitive behavioral therapy techniques were applied to psychological health in four studies. Usability was evaluated in six studies through participant feedback and engagement metrics. Improvements in anxiety, depression, and burnout were observed in four studies, although one reported an increase in depressive symptoms. Conclusions: AI chatbots show potential tools to support the psychological health of health professionals by offering personalized and accessible interventions. Nonetheless, further research is required to establish standardized protocols and validate the effectiveness of these interventions. Future studies should focus on refining chatbot designs and assessing their impact on diverse health professionals. ", doi="10.2196/67682", url="https://humanfactors.jmir.org/2025/1/e67682" } @Article{info:doi/10.2196/50313, author="Hua, Zhong and Yuqing, Song and Qianwen, Liu and Hong, Chen", title="Factors Influencing eHealth Literacy Worldwide: Systematic Review and Meta-Analysis", journal="J Med Internet Res", year="2025", month="Mar", day="10", volume="27", pages="e50313", keywords="meta-analysis", keywords="eHealth literacy", keywords="eHealth", keywords="Technology Acceptance Model", keywords="Literacy and Health Conceptual Framework", keywords="social determinants of health", keywords="digital health", keywords="consumer", abstract="Background: eHealth literacy has increasingly emerged as a critical determinant of health, highlighting the importance of identifying its influencing factors; however, these factors remain unclear. Numerous studies have explored this concept across various populations, presenting an opportunity for a systematic review and synthesis of the existing evidence to better understand eHealth literacy and its key determinants. Objective: This study aimed to provide a systematic review of factors influencing eHealth literacy and to examine their impact across different populations. Methods: We conducted a comprehensive search of papers from PubMed, CNKI, Embase, Web of Science, Cochrane Library, CINAHL, and MEDLINE databases from inception to April 11, 2023. We included all those studies that reported the eHealth literacy status measured with the eHealth Literacy Scale (eHEALS). Methodological validity was assessed with the standardized Joanna Briggs Institute (JBI) critical appraisal tool prepared for cross-sectional studies. Meta-analytic techniques were used to calculate the pooled standardized $\beta$ coefficient with 95\% CIs, while heterogeneity was assessed using I2, the Q test, and $\tau$2. Meta-regressions were used to explore the effect of potential moderators, including participants' characteristics, internet use measured by time or frequency, and country development status. Predictors of eHealth literacy were integrated according to the Literacy and Health Conceptual Framework and the Technology Acceptance Model (TAM). Results: In total, 17 studies met the inclusion criteria for the meta-analysis. Key factors influencing higher eHealth literacy were identified and classified into 3 themes: (1) actions (internet usage: $\beta$=0.14, 95\% CI 0.102-0.182, I2=80.4\%), (2) determinants (age: $\beta$=--0.042, 95\% CI --0.071 to --0.020, I2=80.3\%; ethnicity: $\beta$=--2.613, 95\% CI --4.114 to --1.112, I2=80.2\%; income: $\beta$=0.206, 95\% CI 0.059-0.354, I2=64.6\%; employment status: $\beta$=--1.629, 95\% CI --2.323 to --0.953, I2=99.7\%; education: $\beta$=0.154, 95\% CI 0.101-0.208, I2=58.2\%; perceived usefulness: $\beta$=0.832, 95\% CI 0.131-1.522, I2=68.3\%; and self-efficacy: $\beta$=0.239, 95\% CI 0.129-0.349, I2=0.0\%), and (3) health status factor (disease: $\beta$=--0.177, 95\% CI --0.298 to --0.055, I2=26.9\%). Conclusions: This systematic review, guided by the Literacy and Health Conceptual Framework model, identified key factors influencing eHealth literacy across 3 dimensions: actions (internet usage), determinants (age, ethnicity, income, employment status, education, perceived usefulness, and self-efficacy), and health status (disease). These findings provide valuable guidance for designing interventions to enhance eHealth literacy. Trial Registration: PROSPERO CRD42022383384; https://www.crd.york.ac.uk/PROSPERO/view/CRD42022383384 ", doi="10.2196/50313", url="https://www.jmir.org/2025/1/e50313" } @Article{info:doi/10.2196/48955, author="Howe, Sydney and Uyl-de Groot, Carin and Wehrens, Rik", title="Legitimacy as Social Infrastructure: A Critical Interpretive Synthesis of the Literature on Legitimacy in Health and Technology", journal="JMIR Hum Factors", year="2025", month="Mar", day="5", volume="12", pages="e48955", keywords="legitimacy", keywords="health technology", keywords="infrastructure", keywords="literature review", keywords="technology adoption", keywords="health care governance", keywords="technology acceptance", keywords="health care delivery", keywords="social infrastructure", keywords="critical interpretive synthesis", abstract="Background: As technology is integrated into health care delivery, research on adoption and acceptance of health technologies leaves large gaps in practice and provides limited explanation of how and why certain technologies are adopted and others are not. In these discussions, the concept of legitimacy is omnipresent but often implicit and underdeveloped. There is no agreement about what legitimacy is or how it works across social science disciplines, despite a prolific volume of the literature centering legitimacy. Objective: This study aims to explore the meaning of legitimacy in health and technology as conceptualized in the distinctive disciplines of organization and management studies, science and technology studies, and medical anthropology and sociology, including how legitimacy is produced and used. This allows us to critically combine insights across disciplines and generate new theory. Methods: We conducted a critical interpretive synthesis literature review. Searches were conducted iteratively and were guided by preset eligibility criteria determined through thematic analysis, beginning with the selection of disciplines, followed by journals, and finally articles. We selected disciplines and journals in organization and management studies, science and technology studies, and medical anthropology and sociology using results from the Scopus and Web of Science databases and disciplinary expert--curated journal lists, focusing on the depth of legitimacy conceptualization. We selected 30 journals, yielding 796 abstracts. Results: A total of 97 articles were included. The synthesis of the literature allowed us to produce a novel conceptualization of legitimacy as a form of social infrastructure, approaching legitimacy as a binding fabric of relationships, narratives, and materialities. We argue that the notion of legitimacy as social infrastructure is a flexible and adaptable framework for working with legitimacy both theoretically and practically. Conclusions: The legitimacy as social infrastructure framework can aid both academics and decision makers by providing more coherent and holistic explanations for how and why new technologies are adopted or not in health care practice. For academics, our framework makes legitimacy and technology adoption empirically approachable from an ethnographic perspective; for decision makers, legitimacy as social infrastructure allows for a practical, action-oriented focus that can be assessed iteratively at any stage of the technology development and implementation process. ", doi="10.2196/48955", url="https://humanfactors.jmir.org/2025/1/e48955", url="http://www.ncbi.nlm.nih.gov/pubmed/40053717" } @Article{info:doi/10.2196/58841, author="Cyuzuzo, Callixte and Dukuzimana, Josee Marie and Muhire, Clement and Sheldon Ames, Mathew and Ngwakongnwi, Emmanuel", title="Challenges to Rehabilitation Services in Sub-Saharan Africa From a User, Health System, and Service Provider Perspective: Scoping Review", journal="JMIR Hum Factors", year="2025", month="Feb", day="28", volume="12", pages="e58841", keywords="challenges", keywords="users", keywords="health system", keywords="service providers", keywords="Sub-Saharan Africa", keywords="scoping review", keywords="rehabilitation service", abstract="Background: Rehabilitation aims to restore and optimize the functioning of impaired systems for people with disabilities. It is an integral part of universal health coverage, and access to it is a human right. Objective: We aimed to identify the key challenges to rehabilitation services in Sub-Saharan Africa from a user, health system, and service provider perspective. Methods: This scoping review was conducted in accordance with the 5-stage framework proposed by Arksey and O'Malley. A comprehensive electronic search was run to identify published articles on rehabilitation services in Sub-Saharan Africa. Of the 131 articles retrieved, 83 articles were assessed for eligibility and 15 papers that met the inclusion criteria were considered. Results: The results show that people with disabilities in Sub-Saharan Africa face multifactorial challenges to access rehabilitation services. Poor access to rehabilitation services is associated with less attention given to rehabilitation by governments, which leads to less funding, negative cultural and social beliefs, fewer rehabilitation centers, poorly equipped rehabilitation units, failure of health systems, lack of training to rehabilitation practitioners, and logistical and financial constraints. This review also reveals that digital rehabilitation reduces costs and improves access to services in hard-to-reach geographical areas. However, digital rehabilitation faces challenges as well, including connectivity issues, inaccessibility to technology, a lack of technical knowledge, a lack of privacy, and ethical concerns. Conclusions: People with disabilities face multifactorial challenges to access rehabilitation services in Sub-Saharan Africa. It is therefore critical to address these challenges to optimize patients' health outcomes and offer better rehabilitation services. ", doi="10.2196/58841", url="https://humanfactors.jmir.org/2025/1/e58841" } @Article{info:doi/10.2196/59458, author="Lochhead, Chris and Fisher, B. Robert", title="On the Necessity of Multidisciplinarity in the Development of at-Home Health Monitoring Platforms for Older Adults: Systematic Review", journal="JMIR Hum Factors", year="2025", month="Feb", day="27", volume="12", pages="e59458", keywords="multi-disciplinarity", keywords="gait assessment", keywords="machine learning", keywords="at-home health monitoring", keywords="older adults", keywords="elderly", keywords="artificial intelligence", keywords="AI", keywords="gait", keywords="development", keywords="health monitoring", keywords="monitoring", keywords="systematic review", keywords="monitoring system", keywords="barriers", keywords="caregiver", keywords="efficiency", keywords="effectiveness", abstract="Background: The growth of aging populations globally has increased the demand for new models of care. At-home, computerized health care monitoring is a growing paradigm, which explores the possibility of reducing workloads, lowering the demand for resource-intensive secondary care, and providing more precise and personalized care. Despite the potential societal benefit of autonomous monitoring systems when implemented properly, uptake in health care institutions is slow, and a great volume of research across disciplines encounters similar common barriers to real-world implementation. Objective: The goal of this systematic review was to construct an evaluation framework that can assess research in terms of how well it addresses already identified barriers to application and then use that framework to analyze the literature across disciplines and identify trends between multidisciplinarity and the likelihood of research being developed robustly. Methods: This paper introduces a scoring framework for evaluating how well individual pieces of research address key development considerations using 10 identified common barriers to uptake found during meta-review from different disciplines across the domain of health care monitoring. A scoping review is then conducted using this framework to identify the impact that multidisciplinarity involvement has on the effective development of new monitoring technologies. Specifically, we use this framework to measure the relationship between the use of multidisciplinarity in research and the likelihood that a piece of research will be developed in a way that gives it genuine practical application. Results: We show that viewpoints of multidisciplinarity; namely across computer science and medicine alongside public and patient involvement (PPI) have a significant positive impact in addressing commonly encountered barriers to application research and development according to the evaluation criteria. Using our evaluation metric, multidisciplinary teams score on average 54.3\% compared with 35\% for teams made up of medical experts and social scientists, and 2.68 for technical-based teams, encompassing computer science and engineering. Also identified is the significant effect that involving either caregivers or end users in the research in a co-design or PPI-based capacity has on the evaluation score (29.3\% without any input and between 48.3\% and 36.7\% for end user or caregiver input respectively, on average). Conclusions: This review recommends that, to limit the volume of novel research arbitrarily re-encountering the same issues in the limitations of their work and hence improve the efficiency and effectiveness of research, multidisciplinarity should be promoted as a priority to accelerate the rate of advancement in this field and encourage the development of more technology in this domain that can be of tangible societal benefit. ", doi="10.2196/59458", url="https://humanfactors.jmir.org/2025/1/e59458" } @Article{info:doi/10.2196/57652, author="Iino, Haru and Kizaki, Hayato and Imai, Shungo and Hori, Satoko", title="Medication Management Initiatives Using Wearable Devices: Scoping Review", journal="JMIR Hum Factors", year="2024", month="Nov", day="27", volume="11", pages="e57652", keywords="medication adherence", keywords="scoping review", keywords="database search", keywords="integrated medication management", keywords="drug", keywords="pharmacy", keywords="pharmacology", keywords="pharmacotherapy", keywords="pharmaceutics", keywords="medication", keywords="adherence", keywords="wearable", keywords="synthesis", keywords="review methods", keywords="digital health", abstract="Background: Wearable devices (WDs) have evolved beyond simple fitness trackers to sophisticated health monitors capable of measuring vital signs, such as heart rate and blood oxygen levels. Their application in health care, particularly medication management, is an emerging field poised to significantly enhance patient adherence to treatment regimens. Despite their widespread use and increasing incorporation into clinical trials, a comprehensive review of WDs in terms of medication adherence has not been conducted. Objective: This study aimed to conduct a comprehensive scoping review to evaluate the impact of WDs on medication adherence across a variety of diseases, summarizing key research findings, outcomes, and challenges encountered. Methods: Adhering to PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines, a structured search was conducted across MEDLINE, Web of Science, and Embase databases, covering the literature from January 1, 2010, to September 30, 2022. The search strategy was based on terms related to WDs and medication adherence, specifically focusing on empirical studies to ensure the inclusion of original research findings. Studies were selected based on their relevance to medication adherence, usage of WDs in detecting medication-taking actions, and their role in integrated medication management systems. Results: We screened 657 articles and identified 18 articles. The identified studies demonstrated the diverse applications of WDs in enhancing medication adherence across diseases such as Parkinson disease, diabetes, and cardiovascular conditions. The geographical distribution and publication years of these studies indicate a growing interest in this research area. The studies were divided into three types: (1) studies reporting a correlation between data from WDs or their usage and medication adherence or drug usage as outcomes, (2) studies using WDs to detect the act of medication-taking itself, and (3) studies proposing an integrated medication management system that uses WDs in managing medication. Conclusions: WDs are increasingly being recognized for their potential to enhance medication management and adherence. This review underscores the need for further empirical research to validate the effectiveness of WDs in real-life settings and explore their use in predicting adherence based on activity rhythms and activities. Despite technological advancements, challenges remain regarding the integration of WDs into routine clinical practice. Future research should focus on leveraging the comprehensive data provided by WDs to develop personalized medication management strategies that can improve patient outcomes. ", doi="10.2196/57652", url="https://humanfactors.jmir.org/2024/1/e57652" } @Article{info:doi/10.2196/57931, author="Sattora, Emily and Teelin, Karen and Prendergast, Christopher and Smith, Abigail and Evans, James and Imdad, Aamer", title="Clinical and Biochemical Outcomes in Transgender Individuals Undergoing Hormone Therapy: Protocol for a Systematic Review", journal="JMIR Res Protoc", year="2024", month="Nov", day="12", volume="13", pages="e57931", keywords="transgender", keywords="lipid levels", keywords="hormone therapy", keywords="biochemical outcomes", keywords="clinical outcomes", keywords="comprehensive data", keywords="systematic review", keywords="meta-analysis", keywords="adolescent", keywords="adults", keywords="electronic databases", keywords="testosterone", keywords="estrogen", abstract="Background: Monitoring of various clinical outcomes and parameters, such as lipid levels, is recommended in transgender individuals undergoing hormone therapies. However, comprehensive data to inform these recommendations is scarce. Objective: This study aims to conduct a systematic review and meta-analysis to synthesize evidence from existing literature on the effect of exogenous hormone therapy on clinical and biochemical outcomes for transgender adolescents and adults. Methods: We will search multiple electronic databases and will include prospective and retrospective observational studies with and without a control group. The study population will include transgender individuals undergoing hormone therapy with testosterone or estrogen. Comparisons will include age-matched, cisgender individuals and changes from baseline. Primary outcomes include changes in or the development of abnormal lipid parameters. Secondary outcomes include BMI, weight, height, and blood pressure for age, serum testosterone or estrogen levels, and development of disease including hypertension, diabetes, fatty liver disease, obesity, adverse cardiac events, as well as all-cause mortality. The meta-analysis will pool the studies where applicable, and meta-regressions will be conducted to evaluate effect modifiers. The GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach will be used to evaluate the overall certainty of evidence. Results: We will summarize the selection of the eligible studies using a PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flowchart. The results will be presented in a table summarizing the evidence. Data collection is ongoing, and the paper is expected to be published in Spring 2025. Conclusions: This systematic review will summarize and evaluate the evidence of the clinical and biochemical outcomes associated with hormone therapies for transgender individuals. Trial Registration: PROSPERO CRD42024483138; https://tinyurl.com/yc4sfvnb International Registered Report Identifier (IRRID): PRR1-10.2196/57931 ", doi="10.2196/57931", url="https://www.researchprotocols.org/2024/1/e57931" } @Article{info:doi/10.2196/57036, author="Desai, Chaitali and Dove, Erica and Nanthakumar, Jarshini and Main, Emilia and Colquhoun, Heather and Astell, Arlene and Mihailidis, Alex and Layton, Natasha and Burhan, M. Amer and Chan, Brian and Wang, H. Rosalie", title="Assistive Technology to Support Dementia Management: Protocol for a Scoping Review of Reviews", journal="JMIR Res Protoc", year="2024", month="Nov", day="11", volume="13", pages="e57036", keywords="assistive technology", keywords="assistive products", keywords="dementia", keywords="care partners", keywords="caregivers", keywords="elderly", abstract="Background: In Canada, more than 60\% of persons living with dementia reside in their own homes, and over 25\% rely heavily on their care partners (ie, family members or friends) for assistance with daily activities such as personal hygiene, eating, and walking. Assistive technology (AT) is a key dementia management strategy, helping to maintain health and social support in home and community settings. AT comprises assistive products and services required for safe and effective use. Persons living with dementia and their care partners often require multiple types of AT to maintain their needs, dignity, and autonomy. AT for dementia management is rapidly developing with abundant scientific literature, which can present a challenge to efficiently navigate and extract insights?for policy and personal decision-making. Objective: This scoping review aims to synthesize review-level evidence from published scientific literature on AT to support dementia management for persons living with dementia and their care partners in their homes and communities. Research gaps in knowledge and areas for further investigation into the use and access of AT will be identified. This review will provide an overview of AT types and characteristics and chart the outcomes and conclusions in review-level evidence. Methods: This review will follow the Joanna Briggs Institute's framework for conducting scoping reviews and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. In total, 6 electronic databases will be searched. Articles will be screened according to the ``Population-Concept-Context (PCC)'' framework for eligible studies. Population includes persons living with dementia, their care partners, and health care professionals (eg, therapists or others who recommend AT). Concept includes AT and self-help devices of many types. Context includes homes and communities. A data charting template will guide data extraction, charting, and summarization. A descriptive numerical summary and an overview of the findings will be presented. Data, such as (1) article information (eg, author and year), (2) article characteristics (eg, review type), (3) AT types and characteristics, (4) setting and population characteristics, and (5) key review outcomes and conclusions, will be extracted. Results: A total of 10,978 unique citations were identified across the 6 electronic databases. This review is in the full-text screening stage, which is expected to be completed by October 2024. Conclusions: This review will provide a comprehensive understanding and documentation of the published scientific literature on AT to support dementia management. Findings from this review are expected to provide evidence-based insights on the complexities of AT types, uses, availability, and access. The author group's diverse national and international perspectives may contribute to knowledge exchange and influence standards to improve the daily function, safety, and well-being of persons living with dementia. Trial Registration: Open Science Framework DKSM9; https://osf.io/dksm9 International Registered Report Identifier (IRRID): PRR1-10.2196/57036 ", doi="10.2196/57036", url="https://www.researchprotocols.org/2024/1/e57036" } @Article{info:doi/10.2196/55182, author="Mess, Veronica Elisabeth and Kramer, Frank and Krumme, Julia and Kanelakis, Nico and Teynor, Alexandra", title="Use of Creative Frameworks in Health Care to Solve Data and Information Problems: Scoping Review", journal="JMIR Hum Factors", year="2024", month="Sep", day="13", volume="11", pages="e55182", keywords="creative frameworks", keywords="data and information problems", keywords="data collection", keywords="data processing", keywords="data provision", keywords="health care", keywords="information visualization", keywords="interdisciplinary teams", keywords="user-centered design", keywords="user-centered data design", keywords="user-centric development", abstract="Background: Digitization is vital for data management, especially in health care. However, problems still hinder health care stakeholders in their daily work while collecting, processing, and providing health data or information. Data are missing, incorrect, cannot be collected, or information is inadequately presented. These problems can be seen as data or information problems. A proven way to elicit requirements for (software) systems is by using creative frameworks (eg, user-centered design, design thinking, lean UX [user experience], or service design) or creative methods (eg, mind mapping, storyboarding, 6 thinking hats, or interaction room). However, to what extent they are used to solve data or information-related problems in health care is unclear. Objective: The primary objective of this scoping review is to investigate the use of creative frameworks in addressing data and information problems in health care. Methods: Following JBI guidelines and the PRISMA-ScR framework, this paper analyzes selected papers, answering whether creative frameworks addressed health care data or information problems. Focusing on data problems (elicitation or collection, processing) and information problems (provision or visualization), the review examined German and English papers published between 2018 and 2022 using keywords related to ``data,'' ``design,'' and ``user-centered.'' The database SCOPUS was used. Results: Of the 898 query results, only 23 papers described a data or information problem and a creative method to solve it. These were included in the follow-up analysis and divided into different problem categories: data collection (n=7), data processing (n=1), information visualization (n=11), and mixed problems meaning data and information problem present (n=4). The analysis showed that most identified problems fall into the information visualization category. This could indicate that creative frameworks are particularly suitable for solving information or visualization problems and less for other, more abstract areas such as data problems. The results also showed that most researchers applied a creative framework after they knew what specific (data or information) problem they had (n=21). Only a minority chose a creative framework to identify a problem and realize it was a data or information problem (n=2). In response to these findings, the paper discusses the need for a new approach that addresses health care data and information challenges by promoting collaboration, iterative feedback, and user-centered development. Conclusions: Although the potential of creative frameworks is undisputed, applying these in solving data and information problems is a minority. To harness this potential, a suitable method needs to be developed to support health care system stakeholders. This method could be the User-Centered Data Approach. ", doi="10.2196/55182", url="https://humanfactors.jmir.org/2024/1/e55182" } @Article{info:doi/10.2196/58046, author="M{\"u}ller, Pascal and Jahn, Patrick", title="Cocreative Development of Robotic Interaction Systems for Health Care: Scoping Review", journal="JMIR Hum Factors", year="2024", month="Sep", day="12", volume="11", pages="e58046", keywords="human-robot interaction", keywords="cocreation", keywords="robotics", keywords="user-centered design", keywords="health care", abstract="Background: Robotic technologies present challenges to health care professionals and are therefore rarely used. Barriers such as lack of controllability and adaptability and complex control functions affect the human-robot relationship. In addition to educational opportunities, the possibility of individual adaptation can improve the usability and practical implementation of robotics. Previous work has focused on developments from a technology-centered perspective and has included user interests too late in the process. Objective: This study addresses the following research question: What cocreative research approaches are used in the field of nursing robotics to improve the usability, intended use, and goal-directed application of robotic developments for nurses and to support the nursing process? Methods: This scoping review provides an overview of the topic and the research activities taking place within it. Five databases and the reference lists of the identified publications were searched for studies without further restrictions. Studies were included if they developed and evaluated interaction and control platforms for robotic systems in health care in a cocreative way with end users. Results: The search resulted in 419 hits, of which 3 publications were included. All publications were feasibility or user studies that were mainly carried out in the European Union. The 3 interaction and control platforms presented were all prototypes and not commercially available. In addition to those in need of care, all studies also included family carers and health care professionals. Conclusions: Robotic interaction and control platforms in health care are rarely, if ever, developed and evaluated with feasibility or user studies that include prototypes and end users. While the involvement of end users is crucial, this review emphasizes that all stakeholders, including health care professionals, should participate in the development process to ensure a holistic understanding of application needs and a focus on user experiences and practical health care needs. It is emphasized that the active involvement of end users in the development process is critical to effectively meeting the needs of the target group. Trial Registration: Deutsches Register Klinischer Studien DRKS00034195; https://drks.de/search/de/trial/DRKS00034195 ", doi="10.2196/58046", url="https://humanfactors.jmir.org/2024/1/e58046" } @Article{info:doi/10.2196/52798, author="Ramachandran, Swathi and Chang, Hsiu-Ju and Worthington, Catherine and Kushniruk, Andre and Ib{\'a}{\~n}ez-Carrasco, Francisco and Davies, Hugh and McKee, Geoffrey and Brown, Adalsteinn and Gilbert, Mark and Iyamu, Ihoghosa", title="Digital Competencies and Training Approaches to Enhance the Capacity of Practitioners to Support the Digital Transformation of Public Health: Rapid Review of Current Recommendations", journal="JMIR Public Health Surveill", year="2024", month="Sep", day="9", volume="10", pages="e52798", keywords="digital public health", keywords="digital transformation", keywords="digital transformations", keywords="rapid review", keywords="rapid reviews", keywords="synthesis", keywords="review methods", keywords="review methodology", keywords="competencies", keywords="competency", keywords="training and practice recommendations", keywords="public health workforce", keywords="workforce", keywords="worker", keywords="workers", keywords="practitioner", keywords="practitioners", keywords="public health", keywords="digital health", keywords="training", keywords="continuing education", keywords="skills", keywords="skill", keywords="recommendation", keywords="recommendations", keywords="best practice", keywords="guideline", keywords="guidelines", abstract="Background: The COVID-19 pandemic highlighted gaps in the public health workforce's capacity to deploy digital technologies while upholding ethical, social justice, and health equity principles. Existing public health competency frameworks have not been updated to reflect the prominent role digital technologies play in contemporary public health, and public health training institutions are seeking to integrate digital technologies in their curricula. Objective: As a first step in a multiphase study exploring recommendations for updates to public health competency frameworks within the Canadian public health context, we conducted a rapid review of literature aiming to identify recommendations for digital competencies, training approaches, and inter- or transdisciplinary partnerships that can enhance public health practitioners' capacity to support the digital transformation of public health. Methods: Following the World Health Organization's (2017) guidelines for rapid reviews, a systematic search was conducted on Ovid MEDLINE, Ovid Embase, ERIC (Education Resources Information Center), and Web of Science for peer-reviewed articles. We also searched Google Scholar and various public health agency and public health association websites for gray literature using search terms related to public health, digital health, practice competencies, and training approaches. We included articles with explicit practice competencies and training recommendations related to digital technologies among public health practitioners published between January 2010 and December 2022. We excluded articles describing these concepts in passing or from a solely clinical perspective. Results: Our search returned 2023 titles and abstracts, of which only 12 studies met the inclusion criteria. We found recommendations for new competencies to enable public health practitioners to appropriately use digital technologies that cut across all existing categories of the core competencies for public health framework of the Public Health Agency of Canada. We also identified a new competency category related to data, data systems management, and governance. Training approaches identified include adapted degree-awarding programs like combined public health and informatics or data science degree programs and ongoing professional certifications with integration of practice-based learning in multi- and interdisciplinary training. Disciplines suggested as important to facilitate practice competency and training recommendations included public health, public health informatics, data, information and computer sciences, biostatistics, health communication, and business. Conclusions: Despite the growth of digital technologies in public health, recommendations about practice competencies and training approaches necessary to effectively support the digital transformation of public health remain limited in the literature. Where available, evidence suggests the workforce requires new competencies that cut across and extend existing public health competencies, including new competencies related to the use and protection of new digital data sources, alongside facilitating health communication and promotion functions using digital media. Recommendations also emphasize the need for training approaches that focus on interdisciplinarity through adapted degree-awarding public health training programs and ongoing professional development. ", doi="10.2196/52798", url="https://publichealth.jmir.org/2024/1/e52798" } @Article{info:doi/10.2196/48633, author="Hassan, Masooma and Kushniruk, Andre and Borycki, Elizabeth", title="Barriers to and Facilitators of Artificial Intelligence Adoption in Health Care: Scoping Review", journal="JMIR Hum Factors", year="2024", month="Aug", day="29", volume="11", pages="e48633", keywords="artificial intelligence", keywords="governance", keywords="health information systems", keywords="artificial intelligence adoption", keywords="system implementation", keywords="health care organizations", keywords="health services", keywords="mobile phone", abstract="Background: Artificial intelligence (AI) use cases in health care are on the rise, with the potential to improve operational efficiency and care outcomes. However, the translation of AI into practical, everyday use has been limited, as its effectiveness relies on successful implementation and adoption by clinicians, patients, and other health care stakeholders. Objective: As adoption is a key factor in the successful proliferation of an innovation, this scoping review aimed at presenting an overview of the barriers to and facilitators of AI adoption in health care. Methods: A scoping review was conducted using the guidance provided by the Joanna Briggs Institute and the framework proposed by Arksey and O'Malley. MEDLINE, IEEE Xplore, and ScienceDirect databases were searched to identify publications in English that reported on the barriers to or facilitators of AI adoption in health care. This review focused on articles published between January 2011 and December 2023. The review did not have any limitations regarding the health care setting (hospital or community) or the population (patients, clinicians, physicians, or health care administrators). A thematic analysis was conducted on the selected articles to map factors associated with the barriers to and facilitators of AI adoption in health care. Results: A total of 2514 articles were identified in the initial search. After title and abstract reviews, 50 (1.99\%) articles were included in the final analysis. These articles were reviewed for the barriers to and facilitators of AI adoption in health care. Most articles were empirical studies, literature reviews, reports, and thought articles. Approximately 18 categories of barriers and facilitators were identified. These were organized sequentially to provide considerations for AI development, implementation, and the overall structure needed to facilitate adoption. Conclusions: The literature review revealed that trust is a significant catalyst of adoption, and it was found to be impacted by several barriers identified in this review. A governance structure can be a key facilitator, among others, in ensuring all the elements identified as barriers are addressed appropriately. The findings demonstrate that the implementation of AI in health care is still, in many ways, dependent on the establishment of regulatory and legal frameworks. Further research into a combination of governance and implementation frameworks, models, or theories to enhance trust that would specifically enable adoption is needed to provide the necessary guidance to those translating AI research into practice. Future research could also be expanded to include attempts at understanding patients' perspectives on complex, high-risk AI use cases and how the use of AI applications affects clinical practice and patient care, including sociotechnical considerations, as more algorithms are implemented in actual clinical environments. ", doi="10.2196/48633", url="https://humanfactors.jmir.org/2024/1/e48633" } @Article{info:doi/10.2196/55964, author="Gabarron, Elia and Larbi, Dillys and Rivera-Romero, Octavio and Denecke, Kerstin", title="Human Factors in AI-Driven Digital Solutions for Increasing Physical Activity: Scoping Review", journal="JMIR Hum Factors", year="2024", month="Jul", day="3", volume="11", pages="e55964", keywords="machine learning", keywords="ML", keywords="artificial intelligence", keywords="AI", keywords="algorithm", keywords="algorithms", keywords="predictive model", keywords="predictive models", keywords="predictive analytics", keywords="predictive system", keywords="practical model", keywords="practical models", keywords="deep learning", keywords="human factors", keywords="physical activity", keywords="physical exercise", keywords="healthy living", keywords="active lifestyle", keywords="exercise", keywords="physically active", keywords="digital health", keywords="mHealth", keywords="mobile health", keywords="app", keywords="apps", keywords="application", keywords="applications", keywords="digital technology", keywords="digital intervention", keywords="digital interventions", keywords="smartphone", keywords="smartphones", keywords="PRISMA", abstract="Background: Artificial intelligence (AI) has the potential to enhance physical activity (PA) interventions. However, human factors (HFs) play a pivotal role in the successful integration of AI into mobile health (mHealth) solutions for promoting PA. Understanding and optimizing the interaction between individuals and AI-driven mHealth apps is essential for achieving the desired outcomes. Objective: This study aims to review and describe the current evidence on the HFs in AI-driven digital solutions for increasing PA. Methods: We conducted a scoping review by searching for publications containing terms related to PA, HFs, and AI in the titles and abstracts across 3 databases---PubMed, Embase, and IEEE Xplore---and Google Scholar. Studies were included if they were primary studies describing an AI-based solution aimed at increasing PA, and results from testing the solution were reported. Studies that did not meet these criteria were excluded. Additionally, we searched the references in the included articles for relevant research. The following data were extracted from included studies and incorporated into a qualitative synthesis: bibliographic information, study characteristics, population, intervention, comparison, outcomes, and AI-related information. The certainty of the evidence in the included studies was evaluated using GRADE (Grading of Recommendations Assessment, Development, and Evaluation). Results: A total of 15 studies published between 2015 and 2023 involving 899 participants aged approximately between 19 and 84 years, 60.7\% (546/899) of whom were female participants, were included in this review. The interventions lasted between 2 and 26 weeks in the included studies. Recommender systems were the most commonly used AI technology in digital solutions for PA (10/15 studies), followed by conversational agents (4/15 studies). User acceptability and satisfaction were the HFs most frequently evaluated (5/15 studies each), followed by usability (4/15 studies). Regarding automated data collection for personalization and recommendation, most systems involved fitness trackers (5/15 studies). The certainty of the evidence analysis indicates moderate certainty of the effectiveness of AI-driven digital technologies in increasing PA (eg, number of steps, distance walked, or time spent on PA). Furthermore, AI-driven technology, particularly recommender systems, seems to positively influence changes in PA behavior, although with very low certainty evidence. Conclusions: Current research highlights the potential of AI-driven technologies to enhance PA, though the evidence remains limited. Longer-term studies are necessary to assess the sustained impact of AI-driven technologies on behavior change and habit formation. While AI-driven digital solutions for PA hold significant promise, further exploration into optimizing AI's impact on PA and effectively integrating AI and HFs is crucial for broader benefits. Thus, the implications for innovation management involve conducting long-term studies, prioritizing diversity, ensuring research quality, focusing on user experience, and understanding the evolving role of AI in PA promotion. ", doi="10.2196/55964", url="https://humanfactors.jmir.org/2024/1/e55964" } @Article{info:doi/10.2196/55597, author="Vagnetti, Roberto and Camp, Nicola and Story, Matthew and Ait-Belaid, Khaoula and Mitra, Suvobrata and Zecca, Massimiliano and Di Nuovo, Alessandro and Magistro, Daniele", title="Instruments for Measuring Psychological Dimensions in Human-Robot Interaction: Systematic Review of Psychometric Properties", journal="J Med Internet Res", year="2024", month="Jun", day="5", volume="26", pages="e55597", keywords="psychometric", keywords="human-robot interaction", keywords="psychological dimensions", keywords="robot", keywords="assessment", keywords="systematic review", abstract="Background: Numerous user-related psychological dimensions can significantly influence the dynamics between humans and robots. For developers and researchers, it is crucial to have a comprehensive understanding of the psychometric properties of the available instruments used to assess these dimensions as they indicate the reliability and validity of the assessment. Objective: This study aims to provide a systematic review of the instruments available for assessing the psychological aspects of the relationship between people and social and domestic robots, offering a summary of their psychometric properties and the quality of the evidence. Methods: A systematic review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines across different databases: Scopus, PubMed, and IEEE Xplore. The search strategy encompassed studies meeting the following inclusion criteria: (1) the instrument could assess psychological dimensions related to social and domestic robots, including attitudes, beliefs, opinions, feelings, and perceptions; (2) the study focused on validating the instrument; (3) the study evaluated the psychometric properties of the instrument; (4) the study underwent peer review; and (5) the study was in English. Studies focusing on industrial robots, rescue robots, or robotic arms or those primarily concerned with technology validation or measuring anthropomorphism were excluded. Independent reviewers extracted instrument properties and the methodological quality of their evidence following the Consensus-Based Standards for the Selection of Health Measurement Instruments guidelines. Results: From 3828 identified records, the search strategy yielded 34 (0.89\%) articles that validated and examined the psychometric properties of 27 instruments designed to assess individuals' psychological dimensions in relation to social and domestic robots. These instruments encompass a broad spectrum of psychological dimensions. While most studies predominantly focused on structural validity (24/27, 89\%) and internal consistency (26/27, 96\%), consideration of other psychometric properties was frequently inconsistent or absent. No instrument evaluated measurement error and responsiveness despite their significance in the clinical context. Most of the instruments (17/27, 63\%) were targeted at both adults and older adults (aged ?18 years). There was a limited number of instruments specifically designed for children, older adults, and health care contexts. Conclusions: Given the strong interest in assessing psychological dimensions in the human-robot relationship, there is a need to develop new instruments using more rigorous methodologies and consider a broader range of psychometric properties. This is essential to ensure the creation of reliable and valid measures for assessing people's psychological dimensions regarding social and domestic robots. Among its limitations, this review included instruments applicable to both social and domestic robots while excluding those for other specific types of robots (eg, industrial robots). ", doi="10.2196/55597", url="https://www.jmir.org/2024/1/e55597", url="http://www.ncbi.nlm.nih.gov/pubmed/38682783" } @Article{info:doi/10.2196/53327, author="Karim, Lynn Jalisa and Wan, Rachel and Tabet, S. Rhea and Chiu, S. Derek and Talhouk, Aline", title="Person-Generated Health Data in Women's Health: Scoping Review", journal="J Med Internet Res", year="2024", month="May", day="16", volume="26", pages="e53327", keywords="digital health", keywords="women's health", keywords="mobile health", keywords="health app", keywords="wearables", keywords="femtech", keywords="self-tracking", keywords="personalized health", keywords="person-generated health data", keywords="patient-generated health data", keywords="scoping review", keywords="mobile phone", abstract="Background: The increased pervasiveness of digital health technology is producing large amounts of person-generated health data (PGHD). These data can empower people to monitor their health to promote prevention and management of disease. Women make up one of the largest groups of consumers of digital self-tracking technology. Objective: In this scoping review, we aimed to (1) identify the different areas of women's health monitored using PGHD from connected health devices, (2) explore personal metrics collected through these technologies, and (3) synthesize facilitators of and barriers to women's adoption and use of connected health devices. Methods: Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for scoping reviews, we searched 5 databases for articles published between January 1, 2015, and February 29, 2020. Papers were included if they targeted women or female individuals and incorporated digital health tools that collected PGHD outside a clinical setting. Results: We included a total of 406 papers in this review. Articles on the use of PGHD for women steadily increased from 2015 to 2020. The health areas that the articles focused on spanned several topics, with pregnancy and the postpartum period being the most prevalent followed by cancer. Types of digital health used to collect PGHD included mobile apps, wearables, websites, the Internet of Things or smart devices, 2-way messaging, interactive voice response, and implantable devices. A thematic analysis of 41.4\% (168/406) of the papers revealed 6 themes regarding facilitators of and barriers to women's use of digital health technology for collecting PGHD: (1) accessibility and connectivity, (2) design and functionality, (3) accuracy and credibility, (4) audience and adoption, (5) impact on community and health service, and (6) impact on health and behavior. Conclusions: Leading up to the COVID-19 pandemic, the adoption of digital health tools to address women's health concerns was on a steady rise. The prominence of tools related to pregnancy and the postpartum period reflects the strong focus on reproductive health in women's health research and highlights opportunities for digital technology development in other women's health topics. Digital health technology was most acceptable when it was relevant to the target audience, was seen as user-friendly, and considered women's personalization preferences while also ensuring accuracy of measurements and credibility of information. The integration of digital technologies into clinical care will continue to evolve, and factors such as liability and health care provider workload need to be considered. While acknowledging the diversity of individual needs, the use of PGHD can positively impact the self-care management of numerous women's health journeys. The COVID-19 pandemic has ushered in increased adoption and acceptance of digital health technology. This study could serve as a baseline comparison for how this field has evolved as a result. International Registered Report Identifier (IRRID): RR2-10.2196/26110 ", doi="10.2196/53327", url="https://www.jmir.org/2024/1/e53327", url="http://www.ncbi.nlm.nih.gov/pubmed/38754098" } @Article{info:doi/10.2196/55860, author="Aggarwal, Monica and Hutchison, G. Brian and Kokorelias, M. Kristina and Ramsden, R. Vivian and Ivers, M. Noah and Pinto, Andrew and Uphsur, G. Ross E. and Wong, T. Sabrina and Pimlott, Nick and Slade, Steve", title="The Conceptualization and Measurement of Research Impact in Primary Health Care: Protocol for a Rapid Scoping Review", journal="JMIR Res Protoc", year="2024", month="Apr", day="23", volume="13", pages="e55860", keywords="research impact", keywords="primary health care", keywords="measurement", keywords="definition", keywords="concept", keywords="development", keywords="implementation", keywords="health policy", keywords="policy", keywords="health service", keywords="rapid review", keywords="review", keywords="research", keywords="policies", keywords="societal", keywords="productivity", keywords="literature database", abstract="Background: The generation of research evidence and knowledge in primary health care (PHC) is crucial for informing the development and implementation of interventions and innovations and driving health policy, health service improvements, and potential societal changes. PHC research has broad effects on patients, practices, services, population health, community, and policy formulation. The in-depth exploration of the definition and measures of research impact within PHC is essential for broadening our understanding of research impact in the discipline and how it compares to other health services research. Objective: The objectives of the study are (1) to understand the conceptualizations and measures of research impact within the realm of PHC and (2) to identify methodological frameworks for evaluation and research impact and the benefits and challenges of using these approaches. The forthcoming review seeks to guide future research endeavors and enhance methodologies used in assessing research impact within PHC. Methods: The protocol outlines the rapid review and environmental scan approach that will be used to explore research impact in PHC and will be guided by established frameworks such as the Canadian Academy of Health Sciences Impact Framework and the Canadian Health Services and Policy Research Alliance. The rapid review follows scoping review guidelines (PRISMA-ScR; Preferred Reporting Items for Systematic Review and Meta-Analysis Extension for Scoping Reviews). The environmental scan will be done by consulting with professional organizations, academic institutions, information science, and PHC experts. The search strategy will involve multiple databases, citation and forward citation searching, and manual searches of gray literature databases, think tank websites, and relevant catalogs. We will include gray and scientific literature focusing explicitly on research impact in PHC from high-income countries using the World Bank classification. Publications published in English from 1978 will be considered. The collected papers will undergo a 2-stage independent review process based on predetermined inclusion criteria. The research team will extract data from selected studies based on the research questions and the CRISP (Consensus Reporting Items for Studies in Primary Care) protocol statement. The team will discuss the extracted data, enabling the identification and categorization of key themes regarding research impact conceptualization and measurement in PHC. The narrative synthesis will evolve iteratively based on the identified literature. Results: The results of this study are expected at the end of 2024. Conclusions: The forthcoming review will explore the conceptualization and measurement of research impact in PHC. The synthesis will offer crucial insights that will guide subsequent research, emphasizing the need for a standardized approach that incorporates diverse perspectives to comprehensively gauge the true impact of PHC research. Furthermore, trends and gaps in current methodologies will set the stage for future studies aimed at enhancing our understanding and measurement of research impact in PHC. International Registered Report Identifier (IRRID): PRR1-10.2196/55860 ", doi="10.2196/55860", url="https://www.researchprotocols.org/2024/1/e55860", url="http://www.ncbi.nlm.nih.gov/pubmed/38652900" } @Article{info:doi/10.2196/48463, author="Pannunzio, Valeria and Morales Ornelas, Cristina Hosana and Gurung, Pema and van Kooten, Robert and Snelders, Dirk and van Os, Hendrikus and Wouters, Michel and Tollenaar, Rob and Atsma, Douwe and Kleinsmann, Maaike", title="Patient and Staff Experience of Remote Patient Monitoring---What to Measure and How: Systematic Review", journal="J Med Internet Res", year="2024", month="Apr", day="22", volume="26", pages="e48463", keywords="remote patient monitoring", keywords="telemonitoring", keywords="patient experience", keywords="staff experience", keywords="monitoring", keywords="intervention", keywords="health outcome", keywords="adherence", keywords="patient monitoring", abstract="Background: Patient and staff experience is a vital factor to consider in the evaluation of remote patient monitoring (RPM) interventions. However, no comprehensive overview of available RPM patient and staff experience--measuring methods and tools exists. Objective: This review aimed at obtaining a comprehensive set of experience constructs and corresponding measuring instruments used in contemporary RPM research and at proposing an initial set of guidelines for improving methodological standardization in this domain. Methods: Full-text papers reporting on instances of patient or staff experience measuring in RPM interventions, written in English, and published after January 1, 2011, were considered for eligibility. By ``RPM interventions,'' we referred to interventions including sensor-based patient monitoring used for clinical decision-making; papers reporting on other kinds of interventions were therefore excluded. Papers describing primary care interventions, involving participants under 18 years of age, or focusing on attitudes or technologies rather than specific interventions were also excluded. We searched 2 electronic databases, Medline (PubMed) and EMBASE, on February 12, 2021.We explored and structured the obtained corpus of data through correspondence analysis, a multivariate statistical technique. Results: In total, 158 papers were included, covering RPM interventions in a variety of domains. From these studies, we reported 546 experience-measuring instances in RPM, covering the use of 160 unique experience-measuring instruments to measure 120 unique experience constructs. We found that the research landscape has seen a sizeable growth in the past decade, that it is affected by a relative lack of focus on the experience of staff, and that the overall corpus of collected experience measures can be organized in 4 main categories (service system related, care related, usage and adherence related, and health outcome related). In the light of the collected findings, we provided a set of 6 actionable recommendations to RPM patient and staff experience evaluators, in terms of both what to measure and how to measure it. Overall, we suggested that RPM researchers and practitioners include experience measuring as part of integrated, interdisciplinary data strategies for continuous RPM evaluation. Conclusions: At present, there is a lack of consensus and standardization in the methods used to measure patient and staff experience in RPM, leading to a critical knowledge gap in our understanding of the impact of RPM interventions. This review offers targeted support for RPM experience evaluators by providing a structured, comprehensive overview of contemporary patient and staff experience measures and a set of practical guidelines for improving research quality and standardization in this domain. ", doi="10.2196/48463", url="https://www.jmir.org/2024/1/e48463", url="http://www.ncbi.nlm.nih.gov/pubmed/38648090" } @Article{info:doi/10.2196/50676, author="Haimi, Motti and Wheeler, Quilter Sheila", title="Safety in Teletriage by Nurses and Physicians in the United States and Israel: Narrative Review and Qualitative Study", journal="JMIR Hum Factors", year="2024", month="Mar", day="25", volume="11", pages="e50676", keywords="telephone triage", keywords="teletriage", keywords="telehealth", keywords="telemedicine", keywords="safety", keywords="system error", keywords="human error", keywords="triage", keywords="outcome", keywords="patient safety", abstract="Background: The safety of telemedicine in general and telephone triage (teletriage) safety in particular have been a focus of concern since the 1970s. Today, telehealth, now subsuming teletriage, has a basic structure and process intended to promote safety. However, inadequate telehealth systems may also compromise patient safety. The COVID-19 pandemic accelerated rapid but uneven telehealth growth, both technologically and professionally. Within 5-10 years, the field will likely be more technologically advanced; however, these advances may still outpace professional standards. The need for an evidence-based system is crucial and urgent. Objective: Our aim was to explore ways that developed teletriage systems produce safe outcomes by examining key system components and questioning long-held assumptions. Methods: We examined safety by performing a narrative review of the literature using key terms concerning patient safety in teletriage. In addition, we conducted system analysis of 2 typical formal systems, physician led and nurse led, in Israel and the United States, respectively, and evaluated those systems' respective approaches to safety. Additionally, we conducted in-depth interviews with representative physicians and 1 nurse using a qualitative approach. Results: The review of literature indicated that research on various aspects of telehealth and teletriage safety is still sparse and of variable quality, producing conflicting and inconsistent results. Researchers, possibly unfamiliar with this complicated field, use an array of poorly defined terms and appear to design studies based on unfounded assumptions. The interviews with health care professionals demonstrated several challenges encountered during teletriage, mainly making diagnosis from a distance, treating unfamiliar patients, a stressful atmosphere, working alone, and technological difficulties. However, they reported using several measures that help them make accurate diagnoses and reasonable decisions, thus keeping patient safety, such as using their expertise and intuition, using structured protocols, and considering nonmedical factors and patient preferences (shared decision-making). Conclusions: Remote encounters about acute, worrisome symptoms are time sensitive, requiring decision-making under conditions of uncertainty and urgency. Patient safety and safe professional practice are extremely important in the field of teletriage, which has a high potential for error. This underregulated subspecialty lacks adequate development and substantive research on system safety. Research may commingle terminology and widely different, ill-defined groups of decision makers with wide variation in decision-making skills, clinical training, experience, and job qualifications, thereby confounding results. The rapid pace of telehealth's technological growth creates urgency in identifying safe systems to guide developers and clinicians about needed improvements. ", doi="10.2196/50676", url="https://humanfactors.jmir.org/2024/1/e50676", url="http://www.ncbi.nlm.nih.gov/pubmed/38526526" } @Article{info:doi/10.2196/46490, author="Doreswamy, Nandini and Horstmanshof, Louise", title="Attributes That Influence Human Decision-Making in Complex Health Services: Scoping Review", journal="JMIR Hum Factors", year="2023", month="Dec", day="20", volume="10", pages="e46490", keywords="human attributes", keywords="human decision-making", keywords="rationality", keywords="rational decision-making", keywords="health policy", keywords="health regulation", keywords="health services", keywords="", abstract="Background: Humans currently dominate decision-making in both clinical health services and complex health services such as health policy and health regulation. Many assumptions inherent in health service models today are underpinned by Ramsey's Expected Utility Theory, a prominent theory in the field of economics that is rooted in rationality. Rational, evidence-based metrics currently dominate the culture of decision-making in health policy and regulation. However, as the COVID-19 pandemic has shown, rational metrics alone may not suffice in making better policy and regulatory decisions. There are ethical and moral considerations and other complex factors that cannot be reduced to evidence-based rationality alone. Therefore, this scoping review was undertaken to identify and map the attributes that influence human decision-making in complex health services. Objective: The objective is to identify and map the attributes that influence human decision-making in complex health services that have been reported in the peer-reviewed literature. Methods: This scoping review was designed to answer the following research question: what attributes have been reported in the literature that influence human decision-making in complex health services? A clear, reproducible methodology is provided. It is reported in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) standards and a recognized framework. As the topic of interest merited broad review to scope and understand literature from a holistic viewpoint, a scoping review of literature was appropriate here. Inclusion and exclusion criteria were developed, and a database search undertaken within 4 search systems---ProQuest, Scopus, PubMed, and Web of Science. Results: The results span 46 years, from 1976 to 2022. A total of 167 papers were identified. After removing duplicates, 81 papers remained. Of these, 77 papers were excluded based on the inclusion and exclusion criteria. The remaining 4 papers were found to be relevant. Citation tracking was undertaken, identifying 4 more relevant papers. Thus, a total of 8 papers were included. These papers were reviewed in detail to identify the human attributes mentioned and count the frequency of mentions. A thematic analysis was conducted to identify the themes. Conclusions: The results highlight key themes that underline the complex and nuanced nature of human decision-making. The results suggest that rationality is entrenched and may influence the lexicon of our thinking about decision-making. The results also highlight the counter narrative of decision-making underpinned by uniquely human attributes. This may have ramifications for decision-making in complex health services today. The review itself takes a rational approach, and the methods used were suited to this. International Registered Report Identifier (IRRID): RR2-10.2196/42353 ", doi="10.2196/46490", url="https://humanfactors.jmir.org/2023/1/e46490", url="http://www.ncbi.nlm.nih.gov/pubmed/38117553" } @Article{info:doi/10.2196/50357, author="Wosny, Marie and Strasser, Maria Livia and Hastings, Janna", title="Experience of Health Care Professionals Using Digital Tools in the Hospital: Qualitative Systematic Review", journal="JMIR Hum Factors", year="2023", month="Oct", day="17", volume="10", pages="e50357", keywords="health information technology", keywords="electronic health record", keywords="electronic medical records", keywords="clinical decision support", keywords="health care professionals", keywords="burnout", keywords="qualitative research", abstract="Background: The digitalization of health care has many potential benefits, but it may also negatively impact health care professionals' well-being. Burnout can, in part, result from inefficient work processes related to the suboptimal implementation and use of health information technologies. Although strategies to reduce stress and mitigate clinician burnout typically involve individual-based interventions, emerging evidence suggests that improving the experience of using health information technologies can have a notable impact. Objective: The aim of this systematic review was to collect evidence of the benefits and challenges associated with the use of digital tools in hospital settings with a particular focus on the experiences of health care professionals using these tools. Methods: We conducted a systematic literature review following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines to explore the experience of health care professionals with digital tools in hospital settings. Using a rigorous selection process to ensure the methodological quality and validity of the study results, we included qualitative studies with distinct data that described the experiences of physicians and nurses. A panel of 3 independent researchers performed iterative data analysis and identified thematic constructs. Results: Of the 1175 unique primary studies, we identified 17 (1.45\%) publications that focused on health care professionals' experiences with various digital tools in their day-to-day practice. Of the 17 studies, 10 (59\%) focused on clinical decision support tools, followed by 6 (35\%) studies focusing on electronic health records and 1 (6\%) on a remote patient-monitoring tool. We propose a theoretical framework for understanding the complex interplay between the use of digital tools, experience, and outcomes. We identified 6 constructs that encompass the positive and negative experiences of health care professionals when using digital tools, along with moderators and outcomes. Positive experiences included feeling confident, responsible, and satisfied, whereas negative experiences included frustration, feeling overwhelmed, and feeling frightened. Positive moderators that may reinforce the use of digital tools included sufficient training and adequate workflow integration, whereas negative moderators comprised unfavorable social structures and the lack of training. Positive outcomes included improved patient care and increased workflow efficiency, whereas negative outcomes included increased workload, increased safety risks, and issues with information quality. Conclusions: Although positive and negative outcomes and moderators that may affect the use of digital tools were commonly reported, the experiences of health care professionals, such as their thoughts and emotions, were less frequently discussed. On the basis of this finding, this study highlights the need for further research specifically targeting experiences as an important mediator of clinician well-being. It also emphasizes the importance of considering differences in the nature of specific tools as well as the profession and role of individual users. Trial Registration: PROSPERO CRD42023393883; https://tinyurl.com/2htpzzxj ", doi="10.2196/50357", url="https://humanfactors.jmir.org/2023/1/e50357", url="http://www.ncbi.nlm.nih.gov/pubmed/37847535" } @Article{info:doi/10.2196/47288, author="MacPherson, Megan", title="Immigrant, Refugee, and Indigenous Canadians' Experiences With Virtual Health Care Services: Rapid Review", journal="JMIR Hum Factors", year="2023", month="Oct", day="9", volume="10", pages="e47288", keywords="delivery of health care", keywords="emigrants and immigrants", keywords="health disparate", keywords="indigenous Canadians", keywords="minority and vulnerable populations", keywords="refugees", keywords="telemedicine", abstract="Background: The remote, dispersed, and multicultural population of Canada presents unique challenges for health care services. Currently, virtual care solutions are being offered as an innovative solution to improve access to care. Objective: Given the inequities in health care access faced by immigrant, refugee, and Indigenous Canadians, this review aimed to summarize information obtained from original research regarding these people's experiences with virtual care services in Canada. Methods: We conducted a rapid review following published recommendations. MEDLINE and CINAHL were searched for studies relating to virtual care and Canadian immigrants, refugees, or Indigenous peoples. Peer-reviewed articles of any type were included so long as they included information on the experiences of virtual care service delivery in Canada among the abovementioned groups. Results: This review demonstrates an extreme paucity of evidence examining the experiences of immigrant, refugee, and Indigenous groups with virtual care in Canada. Of the 694 publications screened, 8 were included in this review. A total of 2 studies focused on immigrants and refugees in Canada, with the remaining studies focusing on Indigenous communities. Results demonstrate that virtual care is generally accepted within these communities; however, cultural appropriateness or safety and inequitable access to wireless services in certain communities were among the most cited barriers. Conclusions: Little evidence exists outlining immigrants', refugees', and Indigenous peoples' perspectives on the landscape of virtual care in Canada. The development of virtual care programming should take into consideration the barriers, facilitators, and recommendations outlined in this review to improve equitable access. Further, developers should consult with local community members to ensure the appropriateness of services for immigrant, refugee, and Indigenous communities in Canada. ", doi="10.2196/47288", url="https://humanfactors.jmir.org/2023/1/e47288", url="http://www.ncbi.nlm.nih.gov/pubmed/37812489" } @Article{info:doi/10.2196/44327, author="Almashmoum, Maryam and Cunningham, James and Alkhaldi, Ohoud and Anisworth, John", title="Factors That Affect Knowledge-Sharing Behaviors in Medical Imaging Departments in Cancer Centers: Systematic Review", journal="JMIR Hum Factors", year="2023", month="Jul", day="12", volume="10", pages="e44327", keywords="knowledge management", keywords="knowledge sharing", keywords="medical imaging department", keywords="radiology department", keywords="nuclear medicine department", keywords="facilitators", keywords="barriers", keywords="systematic review", abstract="Background: Knowledge management plays a significant role in health care institutions. It consists of 4 processes: knowledge creation, knowledge capture, knowledge sharing, and knowledge application. The success of health care institutions relies on effective knowledge sharing among health care professionals, so the facilitators and barriers to knowledge sharing must be identified and understood. Medical imaging departments play a key role in cancer centers. Therefore, an understanding of the factors that affect knowledge sharing in medical imaging departments should be sought to increase patient outcomes and reduce medical errors. Objective: The purpose of this systematic review was to identify the facilitators and barriers that affect knowledge-sharing behaviors in medical imaging departments and identify the differences between medical imaging departments in general hospitals and cancer centers. Methods: We performed a systematic search in PubMed Central, EBSCOhost (CINAHL), Ovid MEDLINE, Ovid Embase, Elsevier (Scopus), ProQuest, and Clarivate (Web of Science) in December 2021. Relevant articles were identified by examining the titles and abstracts. In total, 2 reviewers independently screened the full texts of relevant papers according to the inclusion and exclusion criteria. We included qualitative, quantitative, and mixed methods studies that investigated the facilitators and barriers that affect knowledge sharing. We used the Mixed Methods Appraisal Tool to assess the quality of the included articles and narrative synthesis to report the results. Results: A total of 49 articles were selected for the full in-depth analysis, and 38 (78\%) studies were included in the final review, with 1 article added from other selected databases. There were 31 facilitators and 10 barriers identified that affected knowledge-sharing practices in medical imaging departments. These facilitators were divided according to their characteristics into 3 categories: individual, departmental, and technological facilitators. The barriers that hindered knowledge sharing were divided into 4 categories: financial, administrative, technological, and geographical barriers. Conclusions: This review highlighted the factors that influenced knowledge-sharing practices in medical imaging departments in cancer centers and general hospitals. In terms of the facilitators and barriers to knowledge sharing, this study shows that these are the same in medical imaging departments, whether in general hospitals or cancer centers. Our findings can be used as guidelines for medical imaging departments to support knowledge-sharing frameworks and enhance knowledge sharing by understanding the facilitators and barriers. ", doi="10.2196/44327", url="https://humanfactors.jmir.org/2023/1/e44327", url="http://www.ncbi.nlm.nih.gov/pubmed/37436810" } @Article{info:doi/10.2196/43227, author="Han, Rui and Todd, Allyson and Wardak, Sara and Partridge, R. Stephanie and Raeside, Rebecca", title="Feasibility and Acceptability of Chatbots for Nutrition and Physical Activity Health Promotion Among Adolescents: Systematic Scoping Review With Adolescent Consultation", journal="JMIR Hum Factors", year="2023", month="May", day="5", volume="10", pages="e43227", keywords="chatbot", keywords="artificial intelligence", keywords="text message", keywords="adolescent nutrition", keywords="physical activity", keywords="health promotion", abstract="Background: Reducing lifestyle risk behaviors among adolescents depends on access to age-appropriate health promotion information. Chatbots---computer programs designed to simulate conversations with human users---have the potential to deliver health information to adolescents to improve their lifestyle behaviors and support behavior change, but research on the feasibility and acceptability of chatbots in the adolescent population is unknown. Objective: This systematic scoping review aims to evaluate the feasibility and acceptability of chatbots in nutrition and physical activity interventions among adolescents. A secondary aim is to consult adolescents to identify features of chatbots that are acceptable and feasible. Methods: We searched 6 electronic databases from March to April 2022 (MEDLINE, Embase, Joanna Briggs Institute, the Cumulative Index to Nursing and Allied Health, the Association for Computing Machinery library, and the IT database Institute of Electrical and Electronics Engineers). Peer-reviewed studies were included that were conducted in the adolescent population (10-19 years old) without any chronic disease, except obesity or type 2 diabetes, and assessed chatbots used nutrition or physical activity interventions or both that encouraged individuals to meet dietary or physical activity guidelines and support positive behavior change. Studies were screened by 2 independent reviewers, with any queries resolved by a third reviewer. Data were extracted into tables and collated in a narrative summary. Gray literature searches were also undertaken. Results of the scoping review were presented to a diverse youth advisory group (N=16, 13-18 years old) to gain insights into this topic beyond what is published in the literature. Results: The search identified 5558 papers, with 5 (0.1\%) studies describing 5 chatbots meeting the inclusion criteria. The 5 chatbots were supported by mobile apps using a combination of the following features: personalized feedback, conversational agents, gamification, and monitoring of behavior change. Of the 5 studies, 2 (40.0\%) studies focused on nutrition, 2 (40.0\%) studies focused on physical activity, and 1 (20.0\%) focused on both nutrition and physical activity. Feasibility and acceptability varied across the 5 studies, with usage rates above 50\% in 3 (60.0\%) studies. In addition, 3 (60.0\%) studies reported health-related outcomes, with only 1 (20.0\%) study showing promising effects of the intervention. Adolescents presented novel concerns around the use of chatbots in nutrition and physical activity interventions, including ethical concerns and the use of false or misleading information. Conclusions: Limited research is available on chatbots in adolescent nutrition and physical activity interventions, finding insufficient evidence on the acceptability and feasibility of chatbots in the adolescent population. Similarly, adolescent consultation identified issues in the design features that have not been mentioned in the published literature. Therefore, chatbot codesign with adolescents may help ensure that such technology is feasible and acceptable to an adolescent population. ", doi="10.2196/43227", url="https://humanfactors.jmir.org/2023/1/e43227", url="http://www.ncbi.nlm.nih.gov/pubmed/37145858" } @Article{info:doi/10.2196/45297, author="Mujirishvili, Tamara and Maidhof, Caterina and Florez-Revuelta, Francisco and Ziefle, Martina and Richart-Martinez, Miguel and Cabrero-Garc{\'i}a, Julio", title="Acceptance and Privacy Perceptions Toward Video-based Active and Assisted Living Technologies: Scoping Review", journal="J Med Internet Res", year="2023", month="May", day="1", volume="25", pages="e45297", keywords="video-based active assisted living technologies", keywords="video monitoring", keywords="life logging", keywords="user acceptance", keywords="privacy", keywords="older adults", keywords="disability", keywords="eHealth", keywords="virtual assistance", keywords="technology", keywords="assistive technology", keywords="virtual assistant", keywords="virtual reality", abstract="Background: The aging society posits new socioeconomic challenges to which a potential solution is active and assisted living (AAL) technologies. Visual-based sensing systems are technologically among the most advantageous forms of AAL technologies in providing health and social care; however, they come at the risk of violating rights to privacy. With the immersion of video-based technologies, privacy-preserving smart solutions are being developed; however, the user acceptance research about these developments is not yet being systematized. Objective: With this scoping review, we aimed to gain an overview of existing studies examining the viewpoints of older adults and/or their caregivers on technology acceptance and privacy perceptions, specifically toward video-based AAL technology. Methods: A total of 22 studies were identified with a primary focus on user acceptance and privacy attitudes during a literature search of major databases. Methodological quality assessment and thematic analysis of the selected studies were executed and principal findings are summarized. The PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines were followed at every step of this scoping review. Results: Acceptance attitudes toward video-based AAL technologies are rather conditional, and are summarized into five main themes seen from the two end-user perspectives: caregiver and care receiver. With privacy being a major barrier to video-based AAL technologies, security and medical safety were identified as the major benefits across the studies. Conclusions: This review reveals a very low methodological quality of the empirical studies assessing user acceptance of video-based AAL technologies. We propose that more specific and more end user-- and real life--targeting research is needed to assess the acceptance of proposed solutions. ", doi="10.2196/45297", url="https://www.jmir.org/2023/1/e45297", url="http://www.ncbi.nlm.nih.gov/pubmed/37126390" } @Article{info:doi/10.2196/45143, author="Jacob, Christine and Lindeque, Johan and Klein, Alexander and Ivory, Chris and Heuss, Sabina and Peter, K. Marc", title="Assessing the Quality and Impact of eHealth Tools: Systematic Literature Review and Narrative Synthesis", journal="JMIR Hum Factors", year="2023", month="Mar", day="23", volume="10", pages="e45143", keywords="eHealth", keywords="mobile health", keywords="mHealth", keywords="digital health", keywords="technology assessment", keywords="technology adoption", keywords="technology implementation", abstract="Background: Technological advancements have opened the path for many technology providers to easily develop and introduce eHealth tools to the public. The use of these tools is increasingly recognized as a critical quality driver in health care; however, choosing a quality tool from the myriad of tools available for a specific health need does not come without challenges. Objective: This review aimed to systematically investigate the literature to understand the different approaches and criteria used to assess the quality and impact of eHealth tools by considering sociotechnical factors (from technical, social, and organizational perspectives). Methods: A structured search was completed following the participants, intervention, comparators, and outcomes framework. We searched the PubMed, Cochrane, Web of Science, Scopus, and ProQuest databases for studies published between January 2012 and January 2022 in English, which yielded 675 results, of which 40 (5.9\%) studies met the inclusion criteria. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and the Cochrane Handbook for Systematic Reviews of Interventions were followed to ensure a systematic process. Extracted data were analyzed using NVivo (QSR International), with a thematic analysis and narrative synthesis of emergent themes. Results: Similar measures from the different papers, frameworks, and initiatives were aggregated into 36 unique criteria grouped into 13 clusters. Using the sociotechnical approach, we classified the relevant criteria into technical, social, and organizational assessment criteria. Technical assessment criteria were grouped into 5 clusters: technical aspects, functionality, content, data management, and design. Social assessment criteria were grouped into 4 clusters: human centricity, health outcomes, visible popularity metrics, and social aspects. Organizational assessment criteria were grouped into 4 clusters: sustainability and scalability, health care organization, health care context, and developer. Conclusions: This review builds on the growing body of research that investigates the criteria used to assess the quality and impact of eHealth tools and highlights the complexity and challenges facing these initiatives. It demonstrates that there is no single framework that is used uniformly to assess the quality and impact of eHealth tools. It also highlights the need for a more comprehensive approach that balances the social, organizational, and technical assessment criteria in a way that reflects the complexity and interdependence of the health care ecosystem and is aligned with the factors affecting users' adoption to ensure uptake and adherence in the long term. ", doi="10.2196/45143", url="https://humanfactors.jmir.org/2023/1/e45143", url="http://www.ncbi.nlm.nih.gov/pubmed/36843321" } @Article{info:doi/10.2196/43966, author="Joseph, L. Amanda and Monkman, Helen and Kushniruk, Andre and Quintana, Yuri", title="Exploring Patient Journey Mapping and the Learning Health System: Scoping Review", journal="JMIR Hum Factors", year="2023", month="Feb", day="27", volume="10", pages="e43966", keywords="patient journey map", keywords="journey map", keywords="patient health information", keywords="learning health system", keywords="learning health care system", keywords="delivery of health care", keywords="service delivery", keywords="scoping review", keywords="health informatics", keywords="user experience", keywords="data integration", abstract="Background: Journey maps are visualization tools that can facilitate the diagrammatical representation of stakeholder groups by interest or function for comparative visual analysis. Therefore, journey maps can illustrate intersections and relationships between organizations and consumers using products or services. We propose that some synergies may exist between journey maps and the concept of a learning health system (LHS). The overarching goal of an LHS is to use health care data to inform clinical practice and improve service delivery processes and patient outcomes. Objective: The purpose of this review was to assess the literature and establish a relationship between journey mapping techniques and LHSs. Specifically, in this study, we explored the current state of the literature to answer the following research questions: (1) Is there a relationship between journey mapping techniques and an LHS in the literature? (2) Is there a way to integrate the data from journey mapping activities into an LHS? (3) How can the data gleaned from journey map activities be used to inform an LHS? Methods: A scoping review was conducted by querying the following electronic databases: Cochrane Database of Systematic Reviews (Ovid), IEEE Xplore, PubMed, Web of Science, Academic Search Complete (EBSCOhost), APA PsycInfo (EBSCOhost), CINAHL (EBSCOhost), and MEDLINE (EBSCOhost). Two researchers applied the inclusion criteria and assessed all articles by title and abstract in the first screen, using Covidence. Following this, a full-text review of included articles was done, with relevant data extracted, tabulated, and assessed thematically. Results: The initial search yielded 694 studies. Of those, 179 duplicates were removed. Following this, 515 articles were assessed during the first screening phase, and 412 were excluded, as they did not meet the inclusion criteria. Next, 103 articles were read in full, and 95 were excluded, resulting in a final sample of 8 articles that satisfied the inclusion criteria. The article sample can be subsumed into 2 overarching themes: (1) the need to evolve service delivery models in health care, and (2) the potential value of using patient journey data in an LHS. Conclusions: This scoping review demonstrated the gap in knowledge regarding integrating the data from journey mapping activities into an LHS. Our findings highlighted the importance of using the data from patient experiences to enrich an LHS and provide holistic care. To satisfy this gap, the authors intend to continue this investigation to establish the relationship between journey mapping and the concept of LHSs. This scoping review will serve as phase 1 of an investigative series. Phase 2 will entail the creation of a holistic framework to guide and streamline data integration from journey mapping activities into an LHS. Lastly, phase 3 will provide a proof of concept to demonstrate how patient journey mapping activities could be integrated into an LHS. ", doi="10.2196/43966", url="https://humanfactors.jmir.org/2023/1/e43966", url="http://www.ncbi.nlm.nih.gov/pubmed/36848189" } @Article{info:doi/10.2196/37785, author="Wegener, Kauffeldt Emilie and Bergsch{\"o}ld, M. Jenny and Whitmore, Carly and Winters, Marjolein and Kayser, Lars", title="Involving Older People With Frailty or Impairment in the Design Process of Digital Health Technologies to Enable Aging in Place: Scoping Review", journal="JMIR Hum Factors", year="2023", month="Jan", day="27", volume="10", pages="e37785", keywords="eHealth", keywords="cognitive decline", keywords="frail", keywords="aging", keywords="cocreation", keywords="user involvement", keywords="mobile phone", abstract="Background: With an increase in life expectancy globally, the focus on digital health technologies that can enhance physical and mental health among older people with frailty and impairment has increased. Similarly, research interest in how digital health technology can promote well-being and self-management of health in older age has increased, including an increased focus on methods for designing digital health technologies that meet the various medical, psychological, and social needs of older population. Despite the increased focus, there remains a necessity to further understand the needs of this population group to ensure uptake and to avoid introduction of additional challenges when introducing technologies, for example, because of poor technological design. The scope is limited to digital health technologies meant to enable older people with frailty and impairment to age in place. Objective: In this study, we aimed to explore how older people with frailty and impairment are involved in various parts of the design processes of digital health technologies and identify gaps or neglected steps in a user-involving design process. This included a focus on recruitment strategies, contributions, and methods used to address the perspectives, needs, and desires of older people with frailty and impairment in the development of digital health technologies. Methods: A scoping review was conducted in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) reporting from February 2021 to April 2021. Literature searches were conducted in PubMed, Scopus, Embase, and IEEE using a search string covering the concepts of health technology, older people, frailty and impairment, user-centered design, and self-management. Results: In total, 1891 studies were imported for screening from the initial search. A total of 22 studies were included in this review after full-text screening and manual search. Invitation through partners was the most reported recruitment strategy to involve older people with frailty and impairment in the design process of digital health technologies. Furthermore, they were commonly involved in the final evaluation of the development process. Three main gaps identified were the use of outreach approaches to recruit older people with frailty and impairment in the design process of digital health technologies, description of the value of involvement and outcome of the contribution of participants, and knowledge regarding involvement in all parts of the design process. Conclusions: Although there is literature on methods for involving older people with frailty and impairment in the design of digital health technology, there is little methodological dialogue on the nuances of how different methods for involvement relate to and shape the outcome of the development process. ", doi="10.2196/37785", url="https://humanfactors.jmir.org/2023/1/e37785", url="http://www.ncbi.nlm.nih.gov/pubmed/36705959" } @Article{info:doi/10.2196/40210, author="Brobbin, Eileen and Deluca, Paolo and Hemrage, Sofia and Drummond, Colin", title="Acceptability and Feasibility of Wearable Transdermal Alcohol Sensors: Systematic Review", journal="JMIR Hum Factors", year="2022", month="Dec", day="23", volume="9", number="4", pages="e40210", keywords="alcohol consumption", keywords="alcohol monitoring", keywords="digital technology", keywords="transdermal alcohol sensors", keywords="wearables", keywords="acceptability", keywords="feasibility", keywords="monitoring", keywords="sensors", keywords="real-time feedback", keywords="health promotion", keywords="alcohol intake", abstract="Background: Transdermal alcohol sensors (TASs) have the potential to be used to monitor alcohol consumption objectively and continuously. These devices can provide real-time feedback to the user, researcher, or health professional and measure alcohol consumption and peaks of use, thereby addressing some of the limitations of the current methods, including breathalyzers and self-reports. Objective: This systematic review aims to evaluate the acceptability and feasibility of the currently available TAS devices. Methods: A systematic search was conducted in CINAHL, EMBASE, Google Scholar, MEDLINE, PsycINFO, PubMed, and Scopus bibliographic databases in February 2021. Two members of our study team independently screened studies for inclusion, extracted data, and assessed the risk of bias. The study's methodological quality was appraised using the Mixed Methods Appraisal Tool. The primary outcome was TAS acceptability. The secondary outcome was feasibility. The data are presented as a narrative synthesis. Results: We identified and analyzed 22 studies. Study designs included laboratory- and ambulatory-based studies, mixed designs, randomized controlled trials, and focus groups, and the length the device was worn ranged from days to weeks. Although views on TASs were generally positive with high compliance, some factors were indicated as potential barriers and there are suggestions to overcome these. Conclusions: There is a lack of research investigating the acceptability and feasibility of TAS devices as a tool to monitor alcohol consumption in clinical and nonclinical populations. Although preliminary evidence suggests their potential in short-term laboratory-based studies with volunteers, more research is needed to establish long-term daily use with other populations, specifically, in the clinical and the criminal justice system. Trial Registration: PROSPERO CRD42021231027; https://www.crd.york.ac.uk/prospero/display\_record.php?RecordID=231027 ", doi="10.2196/40210", url="https://humanfactors.jmir.org/2022/4/e40210", url="http://www.ncbi.nlm.nih.gov/pubmed/36563030" } @Article{info:doi/10.2196/35882, author="Wilson, Lee and Marasoiu, Mariana", title="The Development and Use of Chatbots in Public Health: Scoping Review", journal="JMIR Hum Factors", year="2022", month="Oct", day="5", volume="9", number="4", pages="e35882", keywords="chatbots", keywords="conversational agents", keywords="public health", keywords="evidence", keywords="scoping review", keywords="health care system", keywords="chatbot development", keywords="digital health", keywords="mental health", keywords="health technology", keywords="COVID-19", keywords="pandemic", keywords="chatbot application", abstract="Background: Chatbots are computer programs that present a conversation-like interface through which people can access information and services. The COVID-19 pandemic has driven a substantial increase in the use of chatbots to support and complement traditional health care systems. However, despite the uptake in their use, evidence to support the development and deployment of chatbots in public health remains limited. Recent reviews have focused on the use of chatbots during the COVID-19 pandemic and the use of conversational agents in health care more generally. This paper complements this research and addresses a gap in the literature by assessing the breadth and scope of research evidence for the use of chatbots across the domain of public health. Objective: This scoping review had 3 main objectives: (1) to identify the application domains in public health in which there is the most evidence for the development and use of chatbots; (2) to identify the types of chatbots that are being deployed in these domains; and (3) to ascertain the methods and methodologies by which chatbots are being evaluated in public health applications. This paper explored the implications for future research on the development and deployment of chatbots in public health in light of the analysis of the evidence for their use. Methods: Following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines for scoping reviews, relevant studies were identified through searches conducted in the MEDLINE, PubMed, Scopus, Cochrane Central Register of Controlled Trials, IEEE Xplore, ACM Digital Library, and Open Grey databases from mid-June to August 2021. Studies were included if they used or evaluated chatbots for the purpose of prevention or intervention and for which the evidence showed a demonstrable health impact. Results: Of the 1506 studies identified, 32 were included in the review. The results show a substantial increase in the interest of chatbots in the past few years, shortly before the pandemic. Half (16/32, 50\%) of the research evaluated chatbots applied to mental health or COVID-19. The studies suggest promise in the application of chatbots, especially to easily automated and repetitive tasks, but overall, the evidence for the efficacy of chatbots for prevention and intervention across all domains is limited at present. Conclusions: More research is needed to fully understand the effectiveness of using chatbots in public health. Concerns with the clinical, legal, and ethical aspects of the use of chatbots for health care are well founded given the speed with which they have been adopted in practice. Future research on their use should address these concerns through the development of expertise and best practices specific to public health, including a greater focus on user experience. ", doi="10.2196/35882", url="https://humanfactors.jmir.org/2022/4/e35882", url="http://www.ncbi.nlm.nih.gov/pubmed/36197708" } @Article{info:doi/10.2196/32330, author="Kirkwood, K. Elizabeth and Clymer, Caitlin and Imbulana, Kheminda and Mozumder, Sumaya and Dibley, J. Michael and Alam, Ashraful Neeloy", title="The Role of mHealth Interventions in Changing Gender Relations: Systematic Review of Qualitative Findings", journal="JMIR Hum Factors", year="2022", month="Jul", day="21", volume="9", number="3", pages="e32330", keywords="mobile health", keywords="mHealth", keywords="gender relations", keywords="systematic review", keywords="low- and middle-income countries", keywords="mobile phone", abstract="Background: The rapid and widespread growth of mobile technologies in low- and middle-income countries can offer groundbreaking ways of disseminating public health interventions. However, gender-based inequalities present a challenge for women in accessing mobile technology. Research has shown that mobile health (mHealth) interventions can affect gender relations in both positive and negative ways; however, few mHealth programs use a gender-sensitive lens when designing, implementing, or analyzing programs. Objective: This systematic review aims to identify and summarize the findings of qualitative research studies that explore the impact of mHealth interventions on gender relations as a result of participating in such initiatives in low- and middle-income countries. Methods: We performed a systematic literature review to examine empirical evidence of changes in gender relations attributed to participation in an mHealth intervention in low- and middle-income countries. Peer-reviewed articles were included based on whether they evaluated an mHealth intervention and were published between 2013 and 2020. Articles using mHealth that solely targeted health workers, did not assess a specific intervention, used mobile technology for data collection only, or were formative or exploratory in nature were excluded. The search terms were entered into 4 key electronic databases---MEDLINE, EMBASE, PsycINFO, and Scopus---generating a comprehensive list of potentially relevant peer-reviewed articles. Thematic analysis was used to identify, analyze, and report the themes that emerged from our data. Results: Of the 578 full-text articles retrieved, 14 (2.4\%) were eligible for inclusion in the study. None of the articles appraised gender from the outset. The articles uncovered findings on gender relations through the course of the intervention or postprogram evaluation. Most studies took place in sub-Saharan Africa, with the remainder in South and Southeast Asia. The articles focused on maternal and child health, HIV diagnosis and treatment, and reproductive health. This review found that mHealth programs could enhance spousal communication, foster emotional support between couples, improve women's self-efficacy and autonomy in seeking health information and services, and increase their involvement in health-related decision-making. Despite the positive impacts, some mHealth interventions had an adverse effect, reinforcing the digital divide, upholding men as gatekeepers of information and sole decision-makers, and exacerbating relationship problems. Conclusions: These results suggest that given the rapid and persistent upscale of mHealth interventions in low- and middle-income settings, it is imperative to design interventions that consider their impact on power dynamics and gender relations. Future research is needed to fill the evidence gaps on gender and mHealth, acknowledging that women are not passive beneficiaries and that they need to actively participate and be empowered by mHealth interventions. ", doi="10.2196/32330", url="https://humanfactors.jmir.org/2022/3/e32330", url="http://www.ncbi.nlm.nih.gov/pubmed/35862143" } @Article{info:doi/10.2196/27250, author="Wissemann, Kathrin Ann and Pit, Winona Sabrina and Serafin, Patrick and Gebhardt, Hansj{\"u}rgen", title="Strategic Guidance and Technological Solutions for Human Resources Management to Sustain an Aging Workforce: Review of International Standards, Research, and Use Cases", journal="JMIR Hum Factors", year="2022", month="Jul", day="21", volume="9", number="3", pages="e27250", keywords="workforce", keywords="HR", keywords="aging", keywords="older people", keywords="standards", keywords="international standards", keywords="occupational health", keywords="blockchain", keywords="AI", keywords="ICT", keywords="strategy", abstract="Background: New technologies offer opportunities to create a healthy, productive, and capable aging workforce. There is little research from an organizational perspective about how technology can help create a sustainable aging workforce. Objective: This study aims to (1) explore how technological solutions in organizations can help create and maintain a healthy, productive, and capable aging workforce; and (2) provide recommendations and strategic guidance that benefit both the aging worker and the organization. Methods: International standardization practices, ethical frameworks, collaborative research, and use cases are used to demonstrate how technological solutions can be translated into practice and formed the basis for the development of a set of recommendations to create and maintain a sustainable aging workforce. Results: Organizations need to look at aging through different lenses to optimize an age-inclusive workforce rather than viewing it by chronological age alone. International standards in technology, human resources management, and aging societies can form part of the solution to improve aging workforces. Digitalization of workplaces, digital literacy, innovation, intergenerational collaboration, and knowledge management form important elements of the international standard on age-inclusive workforce. Using internationally agreed ethical frameworks that consider age bias when designing artificial intelligence--related products and services can help organizations in their approach. Age bias in artificial intelligence development in the workplace can be avoided through inclusive practices. No blockchain application was found yet to improve the aging workforce. Barriers to blockchain adoption include fear of layoffs, worker resistance and lack of blockchain competence, worldwide adoption, support, and funding. Integrating blockchain into the internet of things may allow for improved efficiencies, reduce cost, and resolve workforce capacity problems. Organizations could benefit from implementing or funding wearable technologies for their workers. Recent tools such as the Ageing@Work toolkit consisting of virtual user models and virtual workplace models allow for the adaptation of the work processes and the ergonomics of workplaces to the evolving needs of aging workers. Lastly, selected use cases that may contribute to sustaining an aging workforce are explored (eg, the Exposure-Documentation-System, wireless biomedical sensors, and digital voice notes). Conclusions: The synergy of international standardization and ethical framework tools with research can advance information and communication technology solutions in improving aging workforces. There appears to be a momentum that technological solutions to achieve an age-inclusive workforce will undoubtedly find a stronger place within the global context and is most likely to have increased acceptance of technological applications among aging workers as well as organizations and governments. International standardization, cross-country research, and learning from use cases play an important role to ensure practical, efficient, and ethical implementation of technological solutions to contribute to a sustainable aging workforce. ", doi="10.2196/27250", url="https://humanfactors.jmir.org/2022/3/e27250", url="http://www.ncbi.nlm.nih.gov/pubmed/35862177" } @Article{info:doi/10.2196/34278, author="Bergevi, Julia and Andermo, Susanne and Woldamanuel, Yohannes and Johansson, Unn-Britt and Hagstr{\"o}mer, Maria and Rossen, Jenny", title="User Perceptions of eHealth and mHealth Services Promoting Physical Activity and Healthy Diets: Systematic Review", journal="JMIR Hum Factors", year="2022", month="Jun", day="28", volume="9", number="2", pages="e34278", keywords="acceptability", keywords="behavior change", keywords="engagement", keywords="health technology", keywords="noncommunicable diseases", keywords="usability", keywords="user feedback", keywords="qualitative studies", keywords="physical activity", keywords="healthy diet", abstract="Background: Physical activity and a diet that follows general recommendations can help to prevent noncommunicable diseases. However, most adults do not meet current recommended guidelines, and support for behavior change needs to be strengthened. There is growing evidence that shows the benefits of eHealth and mobile health (mHealth) services in promoting healthy habits; however, their long-term effectiveness is uncertain because of nonadherence. Objective: We aimed to explore users' perceptions of acceptability, engagement, and usability of eHealth and mHealth services that promote physical activity, healthy diets, or both in the primary or secondary prevention of noncommunicable diseases. Methods: We conducted a systematic review with a narrative synthesis. We performed the literature search in PubMed, PsycINFO, and CINAHL electronic databases in February 2021 and July 2021. The search was limited to papers published in English between 2016 and 2021. Papers on qualitative and mixed method studies that encompassed eHealth and mHealth services for adults with a focus on physical activity, healthy diet, or both in the primary or secondary prevention of noncommunicable diseases were included. Three authors screened the studies independently, and 2 of the authors separately performed thematic analysis of qualitative data. Results: With an initial finding of 6308 articles and the removal of 427 duplicates, 23 articles were deemed eligible for inclusion in the review. Based on users' preferences, an overarching theme---eHealth and mHealth services provide value but need to be tailored to individual needs---and 5 subthemes---interactive and integrated; varying and multifunctional; easy, pedagogic, and attractive; individualized and customizable; and reliable---emerged. Conclusions: New evidence on the optimization of digital services that promote physical activity and healthy diets has been synthesized. The findings represent users' perceptions of acceptability, engagement, and usability of eHealth and mHealth services and show that services should be personalized, dynamic, easily manageable, and reliable. These findings can help improve adherence to digital health-promoting services. ", doi="10.2196/34278", url="https://humanfactors.jmir.org/2022/2/e34278", url="http://www.ncbi.nlm.nih.gov/pubmed/35763339" } @Article{info:doi/10.2196/35173, author="Sakur, Fareeya and Ward, Kanesha and Khatri, Nafees Neha and Lau, S. Annie Y.", title="Self-care Behaviors and Technology Used During COVID-19: Systematic Review", journal="JMIR Hum Factors", year="2022", month="Jun", day="21", volume="9", number="2", pages="e35173", keywords="self-care", keywords="self-management", keywords="chronic conditions", keywords="COVID-19", keywords="pandemic", keywords="technology", keywords="digital health", keywords="telehealth", keywords="health technology", abstract="Background: Self-care behaviors are essential for people living with chronic conditions; however, the outbreak of the COVID-19 pandemic has imposed additional complications on their daily routines. Few studies have analyzed how self-care behaviors have changed during COVID-19 and the role of digital technology, especially among people with chronic conditions. Objective: This study aims to review how self-care behaviors have changed for people with chronic conditions during the COVID-19 pandemic, and what technology they have adopted to manage their conditions during that period. Methods: A systematic review was conducted using narrative synthesis. Data were extracted from PubMed, MEDLINE, EMBASE, PsycINFO, CINAHL, and Google Scholar, including articles from December 2019 onward. Eligible studies focused on adults diagnosed with chronic conditions undertaking any self-care tasks in line with the middle-range theory of self-care of chronic illness (ie, self-care maintenance, monitoring, and management). The methodological quality of the included articles was assessed with the McMaster Critical Review Forms for Quantitative or Qualitative Studies. Results: In total, 36 primary research articles were included. Changes to self-care behaviors during COVID-19 among people with chronic conditions were organized according to the middle-range theory of self-care of chronic illness focusing on self-care maintenance (ie, medication adherence, physical activity, and diet control), self-care monitoring (ie, monitoring signs and symptoms), and self-care management (ie, consultations with health care providers). Positive self-care behaviors observed include the following: individuals trying to maintain good glycemic control during COVID-19 increased their medication adherence in 27\% (10/36) of studies; and diet control improved in 50\% (18/36) of studies. Negative self-care behaviors observed include the following: decline in physical activities and increased sedentariness were observed in 65\% (23/36) of studies; poor diet control was observed in 57\% (21/36) of studies; and self-monitoring of health status dropped in 43\% (15/36) of studies. The use of technology to support self-care of chronic conditions during COVID-19 was reported in 72\% (26/36) of studies. The actual use of telehealth in place of physical consultations during COVID-19 was observed in 50\% (18/36) of studies, and other digital technologies (eg, social media apps, smartphone apps, web-based platforms, and web browsing) were used in 50\% (18/36) of studies. Telehealth was discussed and recommended as the default technology in delivering future health care services during COVID-19 and beyond in 77\% (28/36) of studies. Conclusions: This review highlighted the necessity to rethink how models of self-care should continue to address the demands of chronic conditions while being responsive to the imminent threats of infectious diseases. Perhaps the silver lining of COVID-19 is that adoption of digital technology (especially telehealth) among a vast cross-section of people with chronic conditions is possible. Future research should investigate effective ways to incorporate evidence-based digital health tools into these new models of self-care that address the challenges of chronic and infectious conditions. ", doi="10.2196/35173", url="https://humanfactors.jmir.org/2022/2/e35173", url="http://www.ncbi.nlm.nih.gov/pubmed/35442904" } @Article{info:doi/10.2196/37204, author="Le{\'o}n, Alejandra Maria and Pannunzio, Valeria and Kleinsmann, Maaike", title="The Impact of Perioperative Remote Patient Monitoring on Clinical Staff Workflows: Scoping Review", journal="JMIR Hum Factors", year="2022", month="Jun", day="6", volume="9", number="2", pages="e37204", keywords="remote patient monitoring", keywords="telemonitoring", keywords="workflow", keywords="nurses", keywords="physicians", keywords="perioperative care", keywords="perioperative medicine", keywords="telehealth", keywords="mobile phone", abstract="Background: Remote patient monitoring (RPM) interventions are being increasingly implemented in health care environments, given their benefits for different stakeholders. However, the effects of these interventions on the workflow of clinical staff are not always considered in RPM research and practice. Objective: This review explored how contemporary RPM interventions affect clinical staff and their workflows in perioperative settings. Methods: We conducted a scoping review of recent articles reporting the impact of RPM interventions implemented in perioperative settings on clinical staff and their workflow. The databases accessed were Embase and PubMed. A qualitative analysis was performed to identify the main problems and advantages that RPM brings to staff, in addition to the approaches taken to evaluate the impact of those interventions. Different themes were identified in terms of the challenges of RPM for clinical staff as well as in terms of benefits, risk-reduction strategies, and methods for measuring the impact of these interventions on the workflow of clinical staff. Results: A total of 1063 papers were found during the initial search, of which 21 (1.98\%) met the inclusion criteria. Of the 21 included papers, 15 (71\%) focused on evaluating new RPM systems, 4 (19\%) focused on existing systems, and 2 (10\%) were reviews. Conclusions: The reviewed literature shows that the impact on staff work experience is a crucial factor to consider when developing and implementing RPM interventions in perioperative settings. However, we noticed both underdevelopment and lack of standardization in the methods for assessing the impact of these interventions on clinical staff and their workflow. On the basis of the reviewed literature, we recommend the development of more robust methods for evaluating the impact of RPM interventions on staff experience in perioperative care; the adoption of a stronger focus on transition management when introducing these interventions in clinical practice; and the inclusion of longer periods of assessment, including the evaluation of long-term goals. ", doi="10.2196/37204", url="https://humanfactors.jmir.org/2022/2/e37204", url="http://www.ncbi.nlm.nih.gov/pubmed/35666574" } @Article{info:doi/10.2196/35380, author="Silva, Vieira C{\'i}cera Renata Diniz and Lopes, Hor{\'a}cio Rayssa and de Goes Bay Jr, Osvaldo and Martiniano, Santos Claudia and Fuentealba-Torres, Miguel and Arc{\^e}ncio, Alexandre Ricardo and Lap{\~a}o, Velez Lu{\'i}s and Dias, Sonia and Uchoa, Costa Severina Alice da", title="Digital Health Opportunities to Improve Primary Health Care in the Context of COVID-19: Scoping Review", journal="JMIR Hum Factors", year="2022", month="May", day="31", volume="9", number="2", pages="e35380", keywords="digital health", keywords="telehealth", keywords="telemedicine", keywords="primary health care", keywords="quality of care", keywords="COVID-19", keywords="pandemic", keywords="science database", keywords="gray literature", abstract="Background: The COVID-19 pandemic brought social, economic, and health impacts, requiring fast adaptation of health systems. Although information and communication technologies were essential for achieving this objective, the extent to which health systems incorporated this technology is unknown. Objective: The aim of this study was to map the use of digital health strategies in primary health care worldwide and their impact on quality of care during the COVID-19 pandemic. Methods: We performed a scoping review based on the Joanna Briggs Institute manual and guided by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) Extension for Scoping Reviews. A systematic and comprehensive three-step search was performed in June and July 2021 in multidisciplinary health science databases and the gray literature. Data extraction and eligibility were performed by two authors independently and interpreted using thematic analysis. Results: A total of 44 studies were included and six thematic groups were identified: characterization and geographic distribution of studies; nomenclatures of digital strategies adopted; types of information and communication technologies; characteristics of digital strategies in primary health care; impacts on quality of care; and benefits, limitations, and challenges of digital strategies in primary health care. The impacts on organization of quality of care were investigated by the majority of studies, demonstrating the strengthening of (1) continuity of care; (2) economic, social, geographical, time, and cultural accessibility; (3) coordination of care; (4) access; (5) integrality of care; (6) optimization of appointment time; (7) and efficiency. Negative impacts were also observed in the same dimensions, such as reduced access to services and increased inequity and unequal use of services offered, digital exclusion of part of the population, lack of planning for defining the role of professionals, disarticulation of actions with real needs of the population, fragile articulation between remote and face-to-face modalities, and unpreparedness of professionals to meet demands using digital technologies. Conclusions: The results showed the positive and negative impacts of remote strategies on quality of care in primary care and the inability to take advantage of the potential of technologies. This may demonstrate differences in the organization of fast and urgent implementation of digital strategies in primary health care worldwide. Primary health care must strengthen its response capacity, expand the use of information and communication technologies, and manage challenges using scientific evidence since digital health is important and must be integrated into public service. ", doi="10.2196/35380", url="https://humanfactors.jmir.org/2022/2/e35380", url="http://www.ncbi.nlm.nih.gov/pubmed/35319466" } @Article{info:doi/10.2196/30050, author="Yeng, Kandabongee Prosper and Fauzi, Ali Muhammad and Sun, Luyi and Yang, Bian", title="Assessing the Legal Aspects of Information Security Requirements for Health Care in 3 Countries: Scoping Review and Framework Development", journal="JMIR Hum Factors", year="2022", month="May", day="25", volume="9", number="2", pages="e30050", keywords="legal requirement", keywords="information security", keywords="healthcare", keywords="security practice", abstract="Background: The loss of human lives from cyberattacks in health care is no longer a probabilistic quantification but a reality that has begun. In addition, the threat scope is also expanding to involve a threat of national security, among others, resulting in surging data breaches within the health care sector. For that matter, there have been provisions of various legislation, regulations, and information security governance tools such as policies, standards, and directives toward enhancing health care information security--conscious care behavior among users. Meanwhile, in a research scenario, there are no comprehensive required security practices to serve as a yardstick in assessing security practices in health care. Moreover, an analysis of the holistic view of the requirements that need more concentration of management, end users, or both has not been comprehensively developed. Thus, there is a possibility that security practice research will leave out vital requirements. Objective: The objective of this study was to systematically identify, assess, and analyze the state-of-the-art information security requirements in health care. These requirements can be used to develop a framework to serve as a yardstick for measuring the future real security practices of health care staff. Methods: A scoping review was, as a result, adopted to identify, assess, and analyze the information security requirement sources within health care in Norway, Indonesia, and Ghana. Results: Of 188 security and privacy requirement sources that were initially identified, 130 (69.1\%) were fully read by the authors. Subsequently, of these 188 requirement documents, 82 (43.6\%) fully met the inclusion criteria and were accessed and analyzed. In total, 253 security and privacy requirements were identified in this work. The findings were then used to develop a framework to serve as a benchmark for modeling and analyzing health care security practices. Conclusions: On the basis of these findings, a framework for modeling, analyzing, and developing effective security countermeasures, including incentivization measures, was developed. Following this framework, research results of health care security practices would be more reliable and effective than relying on incomprehensive security requirements. ", doi="10.2196/30050", url="https://humanfactors.jmir.org/2022/2/e30050", url="http://www.ncbi.nlm.nih.gov/pubmed/35612891" } @Article{info:doi/10.2196/29767, author="Alwakeel, Lyan and Lano, Kevin", title="Functional and Technical Aspects of Self-management mHealth Apps: Systematic App Search and Literature Review", journal="JMIR Hum Factors", year="2022", month="May", day="25", volume="9", number="2", pages="e29767", keywords="mHealth", keywords="mobile health apps", keywords="mobile apps", keywords="apps", keywords="systematic literature review", keywords="SLR", keywords="Mobile App Rating Scale", keywords="MARS", keywords="smartphone", keywords="iOS", keywords="Android", keywords="mobile phone", abstract="Background: Although the past decade has witnessed the development of many self-management mobile health (mHealth) apps that enable users to monitor their health and activities independently, there is a general lack of empirical evidence on the functional and technical aspects of self-management mHealth apps from a software engineering perspective. Objective: This study aims to systematically identify the characteristics and challenges of self-management mHealth apps, focusing on functionalities, design, development, and evaluation methods, as well as to specify the differences and similarities between published research papers and commercial and open-source apps. Methods: This research was divided into 3 main phases to achieve the expected goal. The first phase involved reviewing peer-reviewed academic research papers from 7 digital libraries, and the second phase involved reviewing and evaluating apps available on Android and iOS app stores using the Mobile Application Rating Scale. Finally, the third phase involved analyzing and evaluating open-source apps from GitHub. Results: In total, 52 research papers, 42 app store apps, and 24 open-source apps were analyzed, synthesized, and reported. We found that the development of self-management mHealth apps requires significant time, effort, and cost because of their complexity and specific requirements, such as the use of machine learning algorithms, external services, and built-in technologies. In general, self-management mHealth apps are similar in their focus, user interface components, navigation and structure, services and technologies, authentication features, and architecture and patterns. However, they differ in terms of the use of machine learning, processing techniques, key functionalities, inference of machine learning knowledge, logging mechanisms, evaluation techniques, and challenges. Conclusions: Self-management mHealth apps may offer an essential means of managing users' health, expecting to assist users in continuously monitoring their health and encourage them to adopt healthy habits. However, developing an efficient and intelligent self-management mHealth app with the ability to reduce resource consumption and processing time, as well as increase performance, is still under research and development. In addition, there is a need to find an automated process for evaluating and selecting suitable machine learning algorithms for the self-management of mHealth apps. We believe that these issues can be avoided or significantly reduced by using a model-driven engineering approach with a decision support system to accelerate and ameliorate the development process and quality of self-management mHealth apps. ", doi="10.2196/29767", url="https://humanfactors.jmir.org/2022/2/e29767", url="http://www.ncbi.nlm.nih.gov/pubmed/35612887" } @Article{info:doi/10.2196/27924, author="Lawrence, Katharine and Chong, Stella and Krelle, Holly and Roberts, Timothy and Thorpe, Lorna and Trinh-Shevrin, Chau and Yi, Stella and Kwon, Simona", title="Chinese Americans' Use of Patient Portal Systems: Scoping Review", journal="JMIR Hum Factors", year="2022", month="Apr", day="1", volume="9", number="2", pages="e27924", keywords="patient portal", keywords="electronic health records", keywords="personal health records", keywords="ehealth", keywords="health equity", keywords="digital divide", keywords="Chinese Americans", keywords="Asian Americans", abstract="Background: Electronic patient portals are increasingly used in health care systems as communication and information-sharing tools and show promise in addressing health care access, quality, and outcomes. However, limited research exists on portal use patterns and practices among diverse patient populations, resulting in the lack of culturally and contextually tailored portal systems for these patients. Objective: This study aimed to summarize existing evidence on the access and use patterns, barriers, and facilitators of patient portals among Chinese Americans, who represent a growing patient population in the United States with unique health care and health technology needs. Methods: The authors conducted a literature search using the PRISMA Protocol for Scoping Reviews (Preferred Reporting Items for Systematic Reviews and Meta-Analyses-ScR) for extracting articles published in major databases (MEDLINE, Embase, and PsycINFO) on patient portals and Chinese Americans. Authors independently reviewed the papers during initial screening and full-text review. The studies were analyzed and coded for the study method type, sample population, and main outcomes of interest. Results: In total, 17 articles were selected for inclusion in the review. The included articles were heterogenous and varied in their study aims, methodologies, sample populations, and outcomes. Major findings identified from the articles include variable patterns of portal access and use among Chinese Americans compared to other racial or ethnic groups, with limited evidence on the specific barriers and facilitators for this group; a preference for cross-sectional quantitative tools such as patient surveys and electronic health record--based data over qualitative or other methodologies; and a pattern of aggregating Chinese American--related data into a larger Asian or Asian American designation. Conclusions: There is limited research evaluating the use patterns, experiences, and needs of Chinese Americans who access and use patient portal systems. Existing research is heterogeneous, largely cross-sectional, and does not disaggregate Chinese Americans from larger Asian demographics. Future research should be devoted to the specific portal use patterns, preferences, and needs of Chinese Americans to help ensure contextually appropriate and acceptable design and implementation of these digital health tools. ", doi="10.2196/27924", url="https://humanfactors.jmir.org/2022/2/e27924", url="http://www.ncbi.nlm.nih.gov/pubmed/35363153" } @Article{info:doi/10.2196/28639, author="Knop, Michael and Weber, Sebastian and Mueller, Marius and Niehaves, Bjoern", title="Human Factors and Technological Characteristics Influencing the Interaction of Medical Professionals With Artificial Intelligence--Enabled Clinical Decision Support Systems: Literature Review", journal="JMIR Hum Factors", year="2022", month="Mar", day="24", volume="9", number="1", pages="e28639", keywords="artificial intelligence", keywords="clinical decision support systems", keywords="CDSS", keywords="decision-making", keywords="diagnostic decision support", keywords="human--computer interaction", keywords="human--AI collaboration", keywords="machine learning", keywords="patient outcomes", keywords="deep learning", keywords="trust", keywords="literature review", abstract="Background: The digitization and automation of diagnostics and treatments promise to alter the quality of health care and improve patient outcomes, whereas the undersupply of medical personnel, high workload on medical professionals, and medical case complexity increase. Clinical decision support systems (CDSSs) have been proven to help medical professionals in their everyday work through their ability to process vast amounts of patient information. However, comprehensive adoption is partially disrupted by specific technological and personal characteristics. With the rise of artificial intelligence (AI), CDSSs have become an adaptive technology with human-like capabilities and are able to learn and change their characteristics over time. However, research has not reflected on the characteristics and factors essential for effective collaboration between human actors and AI-enabled CDSSs. Objective: Our study aims to summarize the factors influencing effective collaboration between medical professionals and AI-enabled CDSSs. These factors are essential for medical professionals, management, and technology designers to reflect on the adoption, implementation, and development of an AI-enabled CDSS. Methods: We conducted a literature review including 3 different meta-databases, screening over 1000 articles and including 101 articles for full-text assessment. Of the 101 articles, 7 (6.9\%) met our inclusion criteria and were analyzed for our synthesis. Results: We identified the technological characteristics and human factors that appear to have an essential effect on the collaboration of medical professionals and AI-enabled CDSSs in accordance with our research objective, namely, training data quality, performance, explainability, adaptability, medical expertise, technological expertise, personality, cognitive biases, and trust. Comparing our results with those from research on non-AI CDSSs, some characteristics and factors retain their importance, whereas others gain or lose relevance owing to the uniqueness of human-AI interactions. However, only a few (1/7, 14\%) studies have mentioned the theoretical foundations and patient outcomes related to AI-enabled CDSSs. Conclusions: Our study provides a comprehensive overview of the relevant characteristics and factors that influence the interaction and collaboration between medical professionals and AI-enabled CDSSs. Rather limited theoretical foundations currently hinder the possibility of creating adequate concepts and models to explain and predict the interrelations between these characteristics and factors. For an appropriate evaluation of the human-AI collaboration, patient outcomes and the role of patients in the decision-making process should be considered. ", doi="10.2196/28639", url="https://humanfactors.jmir.org/2022/1/e28639", url="http://www.ncbi.nlm.nih.gov/pubmed/35323118" } @Article{info:doi/10.2196/28301, author="Meyer, Ashley and Wisniewski, Hannah and Torous, John", title="Coaching to Support Mental Health Apps: Exploratory Narrative Review", journal="JMIR Hum Factors", year="2022", month="Mar", day="8", volume="9", number="1", pages="e28301", keywords="smartphone", keywords="apps", keywords="mental health", keywords="coaching", keywords="engagement", abstract="Background: The therapeutic alliance is crucial for the success of face-to-face therapies. Little is known about how coaching functions and fosters the therapeutic alliance in asynchronous treatment modalities such as smartphone apps. Objective: The aim of this paper was to assess how coaching functions and fosters the therapeutic alliance in asynchronous treatment modalities. Methods: We conducted a selected review to gather preliminary data about the role of coaching in mobile technology use for mental health care. We identified 26 trials using a 2019 review by T{\o}nning et al and a 2021 scoping review by Tokg{\"o}z et al to assess how coaching is currently being used across different studies. Results: Our results showed a high level of heterogeneity as studies used varying types of coaching methods but provided little information about coaching protocols and training. Coaching was feasible by clinicians and nonclinicians, scheduled and on demand, and across all technologies ranging from phone calls to social media. Conclusions: Further research is required to better understand the effects of coaching in mobile mental health treatments, but examples offered from reviewed papers suggest several options to implement coaching today. Coaching based on replicable protocols that are verifiable for fidelity will enable the scaling of this model and a better exploration of the digital therapeutic alliance. ", doi="10.2196/28301", url="https://humanfactors.jmir.org/2022/1/e28301", url="http://www.ncbi.nlm.nih.gov/pubmed/35258468" } @Article{info:doi/10.2196/20702, author="Naeem, Iffat and Quan, Hude and Singh, Shaminder and Chowdhury, Nashit and Chowdhury, Mohammad and Saini, Vineet and TC, Turin", title="Factors Associated With Willingness to Share Health Information: Rapid Review", journal="JMIR Hum Factors", year="2022", month="Feb", day="9", volume="9", number="1", pages="e20702", keywords="health information", keywords="information sharing", keywords="health data", keywords="EMR", keywords="PHR", keywords="mobile phone", abstract="Background: To expand research and strategies to prevent disease, comprehensive and real-time data are essential. Health data are increasingly available from platforms such as pharmaceuticals, genomics, health care imaging, medical procedures, wearable devices, and internet activity. Further, health data are integrated with an individual's sociodemographic information, medical conditions, genetics, treatments, and health care. Ultimately, health information generation and flow are controlled by the patient or participant; however, there is a lack of understanding about the factors that influence willingness to share health information. A synthesis of the current literature on the multifactorial nature of health information sharing preferences is required to understand health information exchange. Objective: The objectives of this review are to identify peer-reviewed literature that reported factors associated with health information sharing and to organize factors into cohesive themes and present a narrative synthesis of factors related to willingness to share health information. Methods: This review uses a rapid review methodology to gather literature regarding willingness to share health information within the context of eHealth, which includes electronic health records, personal health records, mobile health information, general health information, or information on social determinants of health. MEDLINE and Google Scholar were searched using keywords such as electronic health records AND data sharing OR sharing preference OR willingness to share. The search was limited to any population that excluded health care workers or practitioners, and the participants aged ?18 years within the US or Canadian context. The data abstraction process using thematic analysis where any factors associated with sharing health information were highlighted and coded inductively within each article. On the basis of shared meaning, the coded factors were collated into major themes. Results: A total of 26 research articles met our inclusion criteria and were included in the qualitative analysis. The inductive thematic coding process revealed multiple major themes related to sharing health information. Conclusions: This review emphasized the importance of data generators' viewpoints and the complex systems of factors that shape their decision to share health information. The themes explored in this study emphasize the importance of trust at multiple levels to develop effective information exchange partnerships. In the case of improving precision health care, addressing the factors presented here that influence willingness to share information can improve sharing capacity for individuals and allow researchers to reorient their methods to address hesitation in sharing health information. ", doi="10.2196/20702", url="https://humanfactors.jmir.org/2022/1/e20702", url="http://www.ncbi.nlm.nih.gov/pubmed/35138263" } @Article{info:doi/10.2196/30804, author="Nigusie, Adane and Endehabtu, F. Berhanu and Angaw, Abebaw Dessie and Teklu, Alemayehu and Mekonnen, Abebaw Zeleke and Feletto, Marta and Assan, Abraham and Samuel, Assegid and Sheikh, Kabir and Tilahun, Binyam", title="Status of Compassionate, Respectful, and Caring Health Service Delivery: Scoping Review", journal="JMIR Hum Factors", year="2022", month="Feb", day="7", volume="9", number="1", pages="e30804", keywords="compassionate", keywords="respectful", keywords="caring", keywords="CRC", keywords="health care delivery", abstract="Background: A compassionate, respectful, and caring (CRC) health professional is very important for human-centered care, serving clients ethically and with respect, adhering to the professional oath, and serving as a model for young professionals. As countries try to achieve universal health coverage (UHC), quality delivery of health services is crucial. CRC health care is an initiative around the need to provide quality care services to clients and patients. However, there is an evidence gap on the status of CRC health care service delivery. Objective: This scoping review aimed to map global evidence on the status of CRC health service delivery practice. Methods: An exhaustive literature review and Delphi technique were used to answer the 2 research questions: ``What is the current status of CRC health care practices among health workers?'' and ``Is it possible for health professionals, health managers, administrators, and policy makers to incorporate it into their activity while designing strategies that could improve the humanistic and holistic approach to health care provision?'' The studies were searched from the year 2014 to September 2020 using electronic databases such as MEDLINE (PubMed), Cochrane Library, Web of Science, Hinari, and the World Health Organization (WHO) library. Additionally, grey literature such as Google, Google Scholar, and WorldWideScience were scrutinized. Studies that applied any study design and data collection and analysis methods related to CRC care were included. Two authors extracted the data and compared the results. Discrepancies were resolved by discussion, or the third reviewer made the decision. Findings from the existing literature were presented using thematic analysis. Results: A total of 1193 potentially relevant studies were generated from the initial search, and 20 studies were included in the final review. From this review, we identified 5 thematic areas: the status of CRC implementation, facilitators for CRC health care service delivery, barriers to CRC health care delivery, disrespectful and abusive care encountered by patients, and perspectives on CRC. The findings of this review indicated that improving the mechanisms for monitoring health facilities, improving accountability, and becoming aware of the consequences of maltreatment within facilities are critical steps to improving health care delivery practices. Conclusions: This scoping review identified that there is limited CRC service provision. Lack of training, patient flow volume, and bed shortages were found to be the main contributors of CRC health care delivery. Therefore, the health care system should consider the components of CRC in health care delivery during in-service training, pre-service training, monitoring and evaluation, community engagement, workload division, and performance appraisal. ", doi="10.2196/30804", url="https://humanfactors.jmir.org/2022/1/e30804", url="http://www.ncbi.nlm.nih.gov/pubmed/35129450" } @Article{info:doi/10.2196/30359, author="Kane, H{\'e}l{\`e}ne and Gourret Baumgart, Jade and El-Hage, Wissam and Deloyer, Jocelyn and Maes, Christine and Lebas, Marie-Clotilde and Marazziti, Donatella and Thome, Johannes and Fond-Harmant, Laurence and Denis, Fr{\'e}d{\'e}ric", title="Opportunities and Challenges for Professionals in Psychiatry and Mental Health Care Using Digital Technologies During the COVID-19 Pandemic: Systematic Review", journal="JMIR Hum Factors", year="2022", month="Feb", day="4", volume="9", number="1", pages="e30359", keywords="COVID-19", keywords="e--mental health", keywords="professional practices", keywords="quality of care", keywords="telepsychiatry", keywords="videoconferencing", abstract="Background: The COVID-19 pandemic has required psychiatric and mental health professionals to change their practices to reduce the risk of transmission of SARS-CoV-2, in particular by favoring remote monitoring and assessment via digital technologies. Objective: As part of a research project that was cofunded by the French National Research Agency (ARN) and the Centre-Val de Loire Region, the aim of this systematic literature review was to investigate how such uses of digital technologies have been developing. Methods: This systematic review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The search was carried out in the MEDLINE (ie, PubMed) and Cairn databases, as well as in a platform specializing in mental health, Ascodocpsy. The search yielded 558 results for the year 2020. After applying inclusion and exclusion criteria, first on titles and abstracts and then on full texts, 61 articles were included. Results: The analysis of the literature revealed a heterogeneous integration of digital technologies, not only depending on countries, contexts, and local regulations, but also depending on the modalities of care. Notwithstanding these variations, the use of videoconferencing has developed significantly, affecting working conditions and therapeutic relationships. For many psychiatric and mental health professionals, the pandemic has been an opportunity to build up their experience of remote care and, thus, better identify the possibilities and limits of these digital technologies. Conclusions: New uses of such technologies essentially consist of a transition from the classic consultation model toward teleconsultation and make less use of the specific potential of artificial intelligence. As professionals were not prepared for these uses, they were confronted with practical difficulties and ethical questions, such as the place of digital technology in care, confidentiality and protection of personal data, and equity in access to care. The COVID-19 health crisis questions how the organization of health care integrates the possibilities offered by digital technology, in particular to promote the autonomy and empowerment of mental health service users. ", doi="10.2196/30359", url="https://humanfactors.jmir.org/2022/1/e30359", url="http://www.ncbi.nlm.nih.gov/pubmed/34736224" } @Article{info:doi/10.2196/31167, author="Terlouw, Gijs and Kuipers, Derek and Veldmeijer, Lars and van 't Veer, Job and Prins, Jelle and Pierie, Jean-Pierre", title="Boundary Objects as Dialogical Learning Accelerators for Social Change in Design for Health: Systematic Review", journal="JMIR Hum Factors", year="2022", month="Feb", day="3", volume="9", number="1", pages="e31167", keywords="boundary objects", keywords="health", keywords="innovation", keywords="design", keywords="systematic review", abstract="Background: Boundary objects can add value for innovative design and implementation research in health care through their organizational focus and the dynamic structure between ill-structured and tailored use. However, when innovation is approached as a boundary object, more attention will need to be paid to the preimplementation phase. Research and design thinking pay attention to the preimplementation stage but do not have a social or organizational focus per se. The integration of boundary objects in design methodologies can provide a more social and organizational focus in innovative design projects by mapping out the mechanisms that occur at boundaries during design. Four dialogical learning mechanisms that can be triggered at boundaries have been described in the literature: identification, coordination, reflection, and transformation. These mechanisms seem suitable for integration in innovative design research on health. Objective: Focusing on innovation in health, this study aims to find out whether the different learning mechanisms can be linked to studies on health innovation that mention boundary objects as a concept and assess whether the related mechanisms provide insight into the stage of the design and implementation or change process. Methods: The following 6 databases were searched for relevant abstracts: PubMed, Scopus, Education Resources Information Center, PsycINFO, Information Science and Technology Abstracts, and Embase. These databases cover a wide range of published studies in the field of health. Results: Our initial search yielded 3102 records; after removing the duplicates, 2186 (70.47\%) records were screened on the title and abstract, and 25 (0.81\%) papers were included; of the 13 papers where we identified 1 mechanism, 5 (38\%) described an innovation or innovative project, and of the 12 papers where we identified more mechanisms, 9 (75\%) described the development or implementation of an innovation. The reflective mechanism was not identified solely but was present in papers describing a more successful development or implementation project of innovation. In these papers, the predetermined goals were achieved, and the process of integration was relatively smoother. Conclusions: The concept of boundary objects has found its way into health care. Although the idea of a boundary object was introduced to describe how specific artifacts can fulfill a bridging function between different sociocultural sites and thus have a social focus, the focus in the included papers was often on the boundary object itself rather than the social effect. The reflection and transformation mechanisms were underrepresented in the included studies but based on the findings in this review, pursuing to trigger the reflective mechanism in design, development, and implementation projects can lead to a more fluid and smooth integration of innovation into practice. ", doi="10.2196/31167", url="https://humanfactors.jmir.org/2022/1/e31167", url="http://www.ncbi.nlm.nih.gov/pubmed/35113023" } @Article{info:doi/10.2196/30766, author="Kaveladze, T. Benjamin and Wasil, R. Akash and Bunyi, B. John and Ramirez, Veronica and Schueller, M. Stephen", title="User Experience, Engagement, and Popularity in Mental Health Apps: Secondary Analysis of App Analytics and Expert App Reviews", journal="JMIR Hum Factors", year="2022", month="Jan", day="31", volume="9", number="1", pages="e30766", keywords="mental health apps", keywords="engagement", keywords="user experience", keywords="digital mental health", keywords="user retention", abstract="Background: User experience and engagement are critical elements of mental health apps' abilities to support users. However, work examining the relationships among user experience, engagement, and popularity has been limited. Understanding how user experience relates to engagement with and popularity of mental health apps can demonstrate the relationship between subjective and objective measures of app use. In turn, this may inform efforts to develop more effective and appealing mental health apps and ensure that they reach wide audiences. Objective: We aimed to examine the relationship among subjective measures of user experience, objective measures of popularity, and engagement in mental health apps. Methods: We conducted a preregistered secondary data analysis in a sample of 56 mental health apps. To measure user experience, we used expert ratings on the Mobile App Rating Scale (MARS) and consumer ratings from the Apple App Store and Google Play. To measure engagement, we acquired estimates of monthly active users (MAU) and user retention. To measure app popularity, we used download count, total app revenue, and MAU again. Results: MARS total score was moderately positively correlated with app-level revenue (Kendall rank [T]=0.30, P=.002), MAU (T=0.39, P<.001), and downloads (T=0.41, P<.001). However, the MARS total score and each of its subscales (Engagement, Functionality, Aesthetics, and Information) showed extremely small correlations with user retention 1, 7, and 30 days after downloading. Furthermore, the total MARS score only correlated with app store rating at T=0.12, which, at P=.20, did not meet our threshold for significance. Conclusions: More popular mental health apps receive better ratings of user experience than less popular ones. However, user experience does not predict sustained engagement with mental health apps. Thus, mental health app developers and evaluators need to better understand user experience and engagement, as well as to define sustained engagement, what leads to it, and how to create products that achieve it. This understanding might be supported by better collaboration between industry and academic teams to advance a science of engagement. ", doi="10.2196/30766", url="https://humanfactors.jmir.org/2022/1/e30766", url="http://www.ncbi.nlm.nih.gov/pubmed/35099398" } @Article{info:doi/10.2196/31858, author="Kip, Hanneke and Keizer, Julia and da Silva, C. Marcia and Beerlage-de Jong, Nienke and K{\"o}hle, Nadine and Kelders, M. Saskia", title="Methods for Human-Centered eHealth Development: Narrative Scoping Review", journal="J Med Internet Res", year="2022", month="Jan", day="27", volume="24", number="1", pages="e31858", keywords="eHealth", keywords="community-based participatory research", keywords="human-centered design", keywords="CeHRes Roadmap", keywords="internet-based intervention", keywords="technological innovations", abstract="Background: Thorough holistic development of eHealth can contribute to a good fit among the technology, its users, and the context. However, despite the availability of frameworks, not much is known about specific research activities for different aims, phases, and settings. This results in researchers having to reinvent the wheel. Consequently, there is a need to synthesize existing knowledge on research activities for participatory eHealth development processes. Objective: The 3 main goals of this review are to create an overview of the development strategies used in studies based on the CeHRes (Center for eHealth Research) Roadmap, create an overview of the goals for which these methods can be used, and provide insight into the lessons learned about these methods. Methods: We included eHealth development studies that were based on the phases and/or principles of the CeHRes Roadmap. This framework was selected because of its focus on participatory, iterative eHealth design in context and to limit the scope of this review. Data were extracted about the type of strategy used, rationale for using the strategy, research questions, and reported information on lessons learned. The most frequently mentioned lessons learned were summarized using a narrative, inductive approach. Results: In the included 160 papers, a distinction was made between overarching development methods (n=10) and products (n=7). Methods are used to gather new data, whereas products can be used to synthesize previously collected data and support the collection of new data. The identified methods were focus groups, interviews, questionnaires, usability tests, literature studies, desk research, log data analyses, card sorting, Delphi studies, and experience sampling. The identified products were prototypes, requirements, stakeholder maps, values, behavior change strategies, personas, and business models. Examples of how these methods and products were applied in the development process and information about lessons learned were provided. Conclusions: This study shows that there is a plethora of methods and products that can be used at different points in the development process and in different settings. To do justice to the complexity of eHealth development, it seems that multiple strategies should be combined. In addition, we found no evidence for an optimal single step-by-step approach to develop eHealth. Rather, researchers need to select the most suitable research methods for their research objectives, the context in which data are collected, and the characteristics of the participants. This study serves as a first step toward creating a toolkit to support researchers in applying the CeHRes Roadmap to practice. In this way, they can shape the most suitable and efficient eHealth development process. ", doi="10.2196/31858", url="https://www.jmir.org/2022/1/e31858", url="http://www.ncbi.nlm.nih.gov/pubmed/35084359" } @Article{info:doi/10.2196/22325, author="Mercer, Kathryn and Carter, Caitlin and Burns, Catherine and Tennant, Ryan and Guirguis, Lisa and Grindrod, Kelly", title="Including the Reason for Use on Prescriptions Sent to Pharmacists: Scoping Review", journal="JMIR Hum Factors", year="2021", month="Nov", day="25", volume="8", number="4", pages="e22325", keywords="patient safety", keywords="human factors", keywords="patient engagement", keywords="multidisciplinary", abstract="Background: In North America, although pharmacists are obligated to ensure prescribed medications are appropriate, information about a patient's reason for use is not a required component of a legal prescription. The benefits of prescribers including the reason for use on prescriptions is evident in the current literature. However, it is not standard practice to share this information with pharmacists. Objective: Our aim was to characterize the research on how including the reason for use on a prescription impacts pharmacists. Methods: We performed an interdisciplinary scoping review, searching literature in the fields of health care, informatics, and engineering. The following databases were searched between December 2018 and January 2019: PubMed, Institute of Electrical and Electronics Engineers (IEEE), Association for Computing Machinery (ACM), International Pharmaceutical Abstracts (IPA), and EMBASE. Results: A total of 3912 potentially relevant articles were identified, with 9 papers meeting the inclusion criteria. The studies used different terminology (eg, indication, reason for use) and a wide variety of study methodologies, including prospective and retrospective observational studies, randomized controlled trials, and qualitative interviews and focus groups. The results suggest that including the reason for use on a prescription can help the pharmacist catch more errors, reduce the need to contact prescribers, support patient counseling, impact communication, and improve patient safety. Reasons that may prevent prescribers from adding the reason for use information are concerns about workflow and patient privacy. Conclusions: More research is needed to understand how the reason for use information should be provided to pharmacists. In the limited literature to date, there is a consensus that the addition of this information to prescriptions benefits patient safety and enables pharmacists to be more effective. Future research should use an implementation science or theory-based approach to improve prescriber buy-in and, consequently, adoption. ", doi="10.2196/22325", url="https://humanfactors.jmir.org/2021/4/e22325", url="http://www.ncbi.nlm.nih.gov/pubmed/34842545" } @Article{info:doi/10.2196/26181, author="Hill, R. Jordan and Brown, C. Janetta and Campbell, L. Noll and Holden, J. Richard", title="Usability-In-Place---Remote Usability Testing Methods for Homebound Older Adults: Rapid Literature Review", journal="JMIR Form Res", year="2021", month="Nov", day="2", volume="5", number="11", pages="e26181", keywords="mobile usability testing", keywords="usability inspection", keywords="methods", keywords="aging", keywords="literature synthesis", keywords="usability study", keywords="mobile usability", keywords="elderly", keywords="older adults", keywords="remote usability", keywords="mobility restriction", abstract="Background: Technology can benefit older adults in many ways, including by facilitating remote access to services, communication, and socialization for convenience or out of necessity when individuals are homebound. As people, especially older adults, self-quarantined and sheltered in place during the COVID-19 pandemic, the importance of usability-in-place became clear. To understand the remote use of technology in an ecologically valid manner, researchers and others must be able to test usability remotely. Objective: Our objective was to review practical approaches for and findings about remote usability testing, particularly remote usability testing with older adults. Methods: We performed a rapid review of the literature and reported on available methods, their advantages and disadvantages, and practical recommendations. This review also reported recommendations for usability testing with older adults from the literature. Results: Critically, we identified a gap in the literature---a lack of remote usability testing methods, tools, and strategies for older adults, despite this population's increased remote technology use and needs (eg, due to disability or technology experience). We summarized existing remote usability methods that were found in the literature as well as guidelines that are available for conducting in-person usability testing with older adults. Conclusions: We call on the human factors research and practice community to address this gap to better support older adults and other homebound or mobility-restricted individuals. ", doi="10.2196/26181", url="https://formative.jmir.org/2021/11/e26181", url="http://www.ncbi.nlm.nih.gov/pubmed/34726604" } @Article{info:doi/10.2196/28236, author="Asan, Onur and Choudhury, Avishek", title="Research Trends in Artificial Intelligence Applications in Human Factors Health Care: Mapping Review", journal="JMIR Hum Factors", year="2021", month="Jun", day="18", volume="8", number="2", pages="e28236", keywords="artificial intelligence", keywords="human factors", keywords="health care systems", keywords="ecological validity", keywords="usability", keywords="trust", keywords="perception", keywords="workload", abstract="Background: Despite advancements in artificial intelligence (AI) to develop prediction and classification models, little research has been devoted to real-world translations with a user-centered design approach. AI development studies in the health care context have often ignored two critical factors of ecological validity and human cognition, creating challenges at the interface with clinicians and the clinical environment. Objective: The aim of this literature review was to investigate the contributions made by major human factors communities in health care AI applications. This review also discusses emerging research gaps, and provides future research directions to facilitate a safer and user-centered integration of AI into the clinical workflow. Methods: We performed an extensive mapping review to capture all relevant articles published within the last 10 years in the major human factors journals and conference proceedings listed in the ``Human Factors and Ergonomics'' category of the Scopus Master List. In each published volume, we searched for studies reporting qualitative or quantitative findings in the context of AI in health care. Studies are discussed based on the key principles such as evaluating workload, usability, trust in technology, perception, and user-centered design. Results: Forty-eight articles were included in the final review. Most of the studies emphasized user perception, the usability of AI-based devices or technologies, cognitive workload, and user's trust in AI. The review revealed a nascent but growing body of literature focusing on augmenting health care AI; however, little effort has been made to ensure ecological validity with user-centered design approaches. Moreover, few studies (n=5 against clinical/baseline standards, n=5 against clinicians) compared their AI models against a standard measure. Conclusions: Human factors researchers should actively be part of efforts in AI design and implementation, as well as dynamic assessments of AI systems' effects on interaction, workflow, and patient outcomes. An AI system is part of a greater sociotechnical system. Investigators with human factors and ergonomics expertise are essential when defining the dynamic interaction of AI within each element, process, and result of the work system. ", doi="10.2196/28236", url="https://humanfactors.jmir.org/2021/2/e28236", url="http://www.ncbi.nlm.nih.gov/pubmed/34142968" } @Article{info:doi/10.2196/16491, author="Andrade, Evismar and Quinlan, Leo and Harte, Richard and Byrne, Dara and Fallon, Enda and Kelly, Martina and Casey, Siobhan and Kirrane, Frank and O'Connor, Paul and O'Hora, Denis and Scully, Michael and Laffey, John and Pladys, Patrick and Beuch{\'e}e, Alain and {\'O}Laighin, Gearoid", title="Augmenting Critical Care Patient Monitoring Using Wearable Technology: Review of Usability and Human Factors", journal="JMIR Hum Factors", year="2021", month="May", day="25", volume="8", number="2", pages="e16491", keywords="patient monitor", keywords="physiologic monitor", keywords="human factors", keywords="ergonomics", keywords="usability", keywords="user experience", keywords="wearable", keywords="mobile phone", keywords="critical care", abstract="Background: Continuous monitoring of the vital signs of critical care patients is an essential component of critical care medicine. For this task, clinicians use a patient monitor (PM), which conveys patient vital sign data through a screen and an auditory alarm system. Some limitations with PMs have been identified in the literature, such as the need for visual contact with the PM screen, which could result in reduced focus on the patient in specific scenarios, and the amount of noise generated by the PM alarm system. With the advancement of material science and electronic technology, wearable devices have emerged as a potential solution for these problems. This review presents the findings of several studies that focused on the usability and human factors of wearable devices designed for use in critical care patient monitoring. Objective: The aim of this study is to review the current state of the art in wearable devices intended for use by clinicians to monitor vital signs of critical care patients in hospital settings, with a focus on the usability and human factors of the devices. Methods: A comprehensive literature search of relevant databases was conducted, and 20 studies were identified and critically reviewed by the authors. Results: We identified 3 types of wearable devices: tactile, head-mounted, and smartwatch displays. In most cases, these devices were intended for use by anesthesiologists, but nurses and surgeons were also identified as potentially important users of wearable technology in critical care medicine. Although the studies investigating tactile displays revealed their potential to improve clinical monitoring, usability problems related to comfort need to be overcome before they can be considered suitable for use in clinical practice. Only a few studies investigated the usability and human factors of tactile displays by conducting user testing involving critical care professionals. The studies of head-mounted displays (HMDs) revealed that these devices could be useful in critical care medicine, particularly from an ergonomics point of view. By reducing the amount of time the user spends averting their gaze from the patient to a separate screen, HMDs enable clinicians to improve their patient focus and reduce the potential of repetitive strain injury. Conclusions: Researchers and designers of new wearable devices for use in critical care medicine should strive to achieve not only enhanced performance but also enhanced user experience for their users, especially in terms of comfort and ease of use. These aspects of wearable displays must be extensively tested with the intended end users in a setting that properly reflects the intended context of use before their adoption can be considered in clinical settings. ", doi="10.2196/16491", url="https://humanfactors.jmir.org/2021/2/e16491", url="http://www.ncbi.nlm.nih.gov/pubmed/34032574" } @Article{info:doi/10.2196/23796, author="Markert, Carl and Sasangohar, Farzan and Mortazavi, J. Bobak and Fields, Sherecce", title="The Use of Telehealth Technology to Support Health Coaching for Older Adults: Literature Review", journal="JMIR Hum Factors", year="2021", month="Jan", day="29", volume="8", number="1", pages="e23796", keywords="telemedicine", keywords="remote sensing technology", keywords="health coaching", keywords="decision support systems", keywords="clinical", keywords="older adults", abstract="Background: Health coaching is an intervention process for driving behavior change through goal-setting, education, encouragement, and feedback on health-related behaviors. Telehealth systems that include health coaching and remote monitoring are making inroads in managing chronic conditions and may be especially suited for older populations. Objective: This literature review aimed to investigate the current status of health coaching interventions incorporating telehealth technology and the associated effectiveness of this intervention to deliver health care with an emphasis on older adults (aged 65 and older). Methods: A literature review was conducted to identify the research conducted on health coaching combined with remote monitoring for delivering health care to older adults. The Ovid MEDLINE and CINAHL databases were queried using a combination of relevant search terms (including middle aged, aged, older adult, elderly, health coaching, and wellness coaching). The search retrieved 196 papers published from January 2010 to September 2019 in English. Following a systematic review process, the titles and abstracts of the papers retrieved were screened for applicability to health coaching for older adults to define a subset for further review. Papers were excluded if the studied population did not include older adults. The full text of the 42 papers in this subset was then reviewed, and 13 papers related to health coaching combined with remote monitoring for older adults were included in this review. Results: Of the 13 studies reviewed, 10 found coaching supported by telehealth technology to provide effective outcomes. Effectiveness outcomes assessed in the studies included hospital admissions/re-admissions, mortality, hemoglobin A1c (HbA1c) level, body weight, blood pressure, physical activity level, fatigue, quality of life, and user acceptance of the coaching program and technology. Conclusions: Telehealth systems that include health coaching have been implemented in older populations as a viable intervention method for managing chronic conditions with mixed results. Health coaching combined with telehealth may be an effective solution for providing health care to older adults. However, health coaching is predominantly performed by human coaches with limited use of technology to augment or replace the human coach. The opportunity exists to expand health coaching to include automated coaching. ", doi="10.2196/23796", url="http://humanfactors.jmir.org/2021/1/e23796/", url="http://www.ncbi.nlm.nih.gov/pubmed/33512322" } @Article{info:doi/10.2196/22774, author="Silva, G. Anabela and Caravau, Hilma and Martins, Ana and Almeida, Pisco Ana Margarida and Silva, Telmo and Ribeiro, {\'O}scar and Santinha, Gon{\c{c}}alo and Rocha, P. Nelson", title="Procedures of User-Centered Usability Assessment for Digital Solutions: Scoping Review of Reviews Reporting on Digital Solutions Relevant for Older Adults", journal="JMIR Hum Factors", year="2021", month="Jan", day="13", volume="8", number="1", pages="e22774", keywords="mobile phone", keywords="user-centered design", keywords="aged", keywords="review", keywords="telemedicine", abstract="Background: The assessment of usability is a complex process that involves several steps and procedures. It is important to standardize the evaluation and reporting of usability procedures across studies to guide researchers, facilitate comparisons across studies, and promote high-quality usability studies. The first step to standardizing is to have an overview of how usability study procedures are reported across the literature. Objective: This scoping review of reviews aims to synthesize the procedures reported for the different steps of the process of conducting a user-centered usability assessment of digital solutions relevant for older adults and to identify potential gaps in the present reporting of procedures. The secondary aim is to identify any principles or frameworks guiding this assessment in view of a standardized approach. Methods: This is a scoping review of reviews. A 5-stage scoping review methodology was used to identify and describe relevant literature published between 2009 and 2020 as follows: identify the research question, identify relevant studies, select studies for review, chart data from selected literature, and summarize and report results. The research was conducted on 5 electronic databases: PubMed, ACM Digital Library, IEEE, Scopus, and Web of Science. Reviews that met the inclusion criteria (reporting on user-centered usability evaluation procedures for any digital solution that could be relevant for older adults and were published in English) were identified, and data were extracted for further analysis regarding study evaluators, study participants, methods and techniques, tasks, and test environment. Results: A total of 3958 articles were identified. After a detailed screening, 20 reviews matched the eligibility criteria. The characteristics of the study evaluators and participants and task procedures were only briefly and differently reported. The methods and techniques used for the assessment of usability are the topics that were most commonly and comprehensively reported in the reviews, whereas the test environment was seldom and poorly characterized. Conclusions: A lack of a detailed description of several steps of the process of assessing usability and no evidence on good practices of performing it suggests that there is a need for a consensus framework on the assessment of user-centered usability evaluation. Such a consensus would inform researchers and allow standardization of procedures, which are likely to result in improved study quality and reporting, increased sensitivity of the usability assessment, and improved comparability across studies and digital solutions. Our findings also highlight the need to investigate whether different ways of assessing usability are more sensitive than others. These findings need to be considered in light of review limitations. ", doi="10.2196/22774", url="http://humanfactors.jmir.org/2021/1/e22774/", url="http://www.ncbi.nlm.nih.gov/pubmed/33439128" } @Article{info:doi/10.2196/15052, author="Andrade, Evismar and Quinlan, Leo and Harte, Richard and Byrne, Dara and Fallon, Enda and Kelly, Martina and Casey, Siobhan and Kirrane, Frank and O'Connor, Paul and O'Hora, Denis and Scully, Michael and Laffey, John and Pladys, Patrick and Beuch{\'e}e, Alain and {\'O}Laighin, Gear{\'o}id", title="Novel Interface Designs for Patient Monitoring Applications in Critical Care Medicine: Human Factors Review", journal="JMIR Hum Factors", year="2020", month="Jul", day="3", volume="7", number="3", pages="e15052", keywords="interface design", keywords="usability", keywords="situation awareness", keywords="graphical display", keywords="satisfaction", keywords="response time", keywords="accuracy", keywords="anesthesiology", keywords="critical care", keywords="performance", keywords="ecological display", abstract="Background: The patient monitor (PM) is one of the most commonly used medical devices in hospitals worldwide. PMs are used to monitor patients' vital signs in a wide variety of patient care settings, especially in critical care settings, such as intensive care units. An interesting observation is that the design of PMs has not significantly changed over the past 2 decades, with the layout and structure of PMs more or less unchanged, with incremental changes in design being made rather than transformational changes. Thus, we believe it well-timed to review the design of novel PM interfaces, with particular reference to usability and human factors. Objective: This paper aims to review innovations in PM design proposed by researchers and explore how clinicians responded to these design changes. Methods: A literature search of relevant databases, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, identified 16 related studies. A detailed description of the interface design and an analysis of each novel PM were carried out, including a detailed analysis of the structure of the different user interfaces, to inform future PM design. The test methodologies used to evaluate the different designs are also presented. Results: Most of the studies included in this review identified some level of improvement in the clinician's performance when using a novel display in comparison with the traditional PM. For instance, from the 16 reviewed studies, 12 studies identified an improvement in the detection and response times, and 10 studies identified an improvement in the accuracy or treatment efficiency. This indicates that novel displays have the potential to improve the clinical performance of nurses and doctors. However, the outcomes of some of these studies are weakened because of methodological deficiencies. These deficiencies are discussed in detail in this study. Conclusions: More careful study design is warranted to investigate the user experience and usability of future novel PMs for real time vital sign monitoring, to establish whether or not they could be used successfully in critical care. A series of recommendations on how future novel PM designs and evaluations can be enhanced are provided. ", doi="10.2196/15052", url="https://humanfactors.jmir.org/2020/3/e15052", url="http://www.ncbi.nlm.nih.gov/pubmed/32618574" } @Article{info:doi/10.2196/15038, author="Han, Hae-Ra and Gleason, T. Kelly and Sun, Chun-An and Miller, N. Hailey and Kang, Jin Soo and Chow, Sotera and Anderson, Rachel and Nagy, Paul and Bauer, Tom", title="Using Patient Portals to Improve Patient Outcomes: Systematic Review", journal="JMIR Hum Factors", year="2019", month="Dec", day="19", volume="6", number="4", pages="e15038", keywords="patient portal", keywords="intervention study", keywords="systematic review", abstract="Background: With the advent of electronic health record (EHR) systems, there is increasing attention on the EHR system with regard to its use in facilitating patients to play active roles in their care via secure patient portals. However, there is no systematic review to comprehensively address patient portal interventions and patient outcomes. Objective: This study aimed to synthesize evidence with regard to the characteristics and psychobehavioral and clinical outcomes of patient portal interventions. Methods: In November 2018, we conducted searches in 3 electronic databases, including PubMed, EMBASE, and Cumulative Index to Nursing and Allied Health Literature, and a total of 24 articles met the eligibility criteria. Results: All but 3 studies were conducted in the United States. The types of study designs varied, and samples predominantly involved non-Hispanic white and highly educated patients with sizes ranging from 50 to 22,703. Most of the portal interventions used tailored alerts or educational resources tailored to the patient's condition. Patient portal interventions lead to improvements in a wide range of psychobehavioral outcomes, such as health knowledge, self-efficacy, decision making, medication adherence, and preventive service use. Effects of patient portal interventions on clinical outcomes including blood pressure, glucose, cholesterol, and weight loss were mixed. Conclusions: Patient portal interventions were overall effective in improving a few psychological outcomes, medication adherence, and preventive service use. There was insufficient evidence to support the use of patient portals to improve clinical outcomes. Understanding the role of patient portals as an effective intervention strategy is an essential step to encourage patients to be actively engaged in their health care. ", doi="10.2196/15038", url="http://humanfactors.jmir.org/2019/4/e15038/", url="http://www.ncbi.nlm.nih.gov/pubmed/31855187" } @Article{info:doi/10.2196/11544, author="Grace-Farfaglia, Patricia", title="Social Cognitive Theories and Electronic Health Design: Scoping Review", journal="JMIR Hum Factors", year="2019", month="Jul", day="19", volume="6", number="3", pages="e11544", keywords="social theory", keywords="design", keywords="health promotion", keywords="behavioral economics", keywords="social support", keywords="social media", keywords="serious games", abstract="Background: There are several social cognitive theories (SCTs) and models that support platform design in electronic health (eHealth) promotion trials. The rationale for this scoping review was to determine how social design features (informational aid, expressive support, gaming, and tailored content) are used to promote self-efficacy, engagement, knowledge, and behavior change. Objective: This study aimed to review a broad spectrum of digital health interventions in the literature seeking trials that use SCTs for the design of eHealth applications. Methods: The author conducted a systematic scoping review of 161 Web-based health interventions from published randomized clinical trials using 1 or more tools to address the social cognitive determinants in their website design from January 2006 to April 2016. An iterative approach was used in the selection of studies and data extraction. The studies were analyzed for quality and coded for type of social design features employed. Results: Expressive interaction tools were found in 48.6\% (54/111) of studies categorized as a strong recommendation by the Joanna Briggs Institute criteria. Overall, less than half of the studies addressed participant social support and motivational needs (43.8\%). The vast majority of studies (100\%) relied on the use of the Web for delivery of informational aid and tailored content for the individual participant (75.9\%). Conclusions: This review fills a research gap by linking social theory to Web strategy to improve the impact and sustainability of eHealth interventions. A Digital Health Intervention Model was developed to provide a framework to enhance future Web-based health intervention design and execution. ", doi="10.2196/11544", url="https://humanfactors.jmir.org/2019/3/e11544/", url="http://www.ncbi.nlm.nih.gov/pubmed/31325290" } @Article{info:doi/10.2196/humanfactors.9049, author="Waite, Marion and Martin, Clare and Franklin, Rachel and Duce, David and Harrison, Rachel", title="Human Factors and Data Logging Processes With the Use of Advanced Technology for Adults With Type 1 Diabetes: Systematic Integrative Review", journal="JMIR Hum Factors", year="2018", month="Mar", day="15", volume="5", number="1", pages="e11", keywords="adult", keywords="type 1 diabetes mellitus", keywords="T1D", keywords="technology", keywords="self-management", keywords="self-care", keywords="telehealth", keywords="telemedicine", keywords="reminder system", keywords="continuous glucose monitoring", keywords="Sensor-augmented pump therapy", keywords="closed loop systems", keywords="adherence", keywords="compliance", keywords="barrier", keywords="usability", abstract="Background: People with type 1 diabetes (T1D) undertake self-management to prevent short and long-term complications. Advanced technology potentially supports such activities but requires consideration of psychological and behavioral constructs and usability issues. Economic factors and health care provider capacity influence access and uptake of advanced technology. Previous reviews have focused upon clinical outcomes or were descriptive or have synthesized studies on adults with those on children and young people where human factors are different. Objective: This review described and examined the relationship between human factors and adherence with technology for data logging processes in adults with T1D. Methods: A systematic literature search was undertaken by using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Quality appraisal was undertaken and data were abstracted and categorized into the themes that underpinned the human factor constructs that were examined. Results: A total of 18 studies were included. A total of 6 constructs emerged from the data analysis: the relationship between adherence to data logging and measurable outcomes; satisfaction with the transition to advanced technology for self-management; use of advanced technology and time spent on diabetes-related activities; strategies to mediate the complexities of diabetes and the use of advanced technology; cognition in the wild; and meanings, views, and perspectives from the users of technology. Conclusions: Increased treatment satisfaction was found on transition from traditional to advanced technology use---insulin pump and continuous glucose monitoring (CGM); the most significant factor was when blood glucose levels were consistently <7.00 mmol/L (P ?.01). Participants spent considerable time on their diabetes self-care. Logging of data was positively correlated with increasing age when using an app that provided meaningful feedback (regression coefficient=55.8 recordings/year; P ?.01). There were benefits of CGM for older people in mediating complexities and fears of hypoglycemia with significant differences in well-being (P ?.001). Qualitative studies explored the contextual use and uptake of technology. The results suggested frustrations with CGM, continuous subcutaneous insulin infusion, calibration of devices, and alarms. Furthermore implications for ``body image'' and the way in which ``significant others'' impacted on the behavior and attitude of the individual toward technology use. There were wide variations in the normal use of and interaction with technology across a continuum of sociocultural contexts, which has implications for the way in which future technologies should be designed. Quantitative studies were limited by small sample sizes, making it difficult to generalize findings to other contexts. This was further limited by a sample that was predominantly white, well-controlled, and engaged with self-care. The use of critical appraisal frameworks demonstrated where research into human factors and data logging processes of individuals could be improved. This included engaging people in the design of the technology, especially hard-to-reach or marginalized groups. ", doi="10.2196/humanfactors.9049", url="http://humanfactors.jmir.org/2018/1/e11/", url="http://www.ncbi.nlm.nih.gov/pubmed/29535079" } @Article{info:doi/10.2196/humanfactors.5083, author="Jatoba, Alessandro and Burns, Marie Catherine and Vidal, Rodriguez Mario Cesar and Carvalho, Rodrigues Paulo Victor", title="Designing for Risk Assessment Systems for Patient Triage in Primary Health Care: A Literature Review", journal="JMIR Hum Factors", year="2016", month="Aug", day="15", volume="3", number="2", pages="e21", keywords="primary health care", keywords="triage", keywords="clinical decision support systems", keywords="health information systems", abstract="Background: This literature review covers original journal papers published between 2011 and 2015. These papers review the current status of research on the application of human factors and ergonomics in risk assessment systems' design to cope with the complexity, singularity, and danger in patient triage in primary health care. Objective: This paper presents a systematic literature review that aims to identify, analyze, and interpret the application of available evidence from human factors and ergonomics to the design of tools, devices, and work processes to support risk assessment in the context of health care. Methods: Electronic search was performed on 7 bibliographic databases of health sciences, engineering, and computer sciences disciplines. The quality and suitability of primary studies were evaluated, and selected papers were classified according to 4 classes of outcomes. Results: A total of 1845 papers were retrieved by the initial search, culminating in 16 selected for data extraction after the application of inclusion and exclusion criteria and quality and suitability evaluation. Conclusions: Results point out that the study of the implications of the lack of understanding about real work performance in designing for risk assessment in health care is very specific, little explored, and mostly focused on the development of tools. ", doi="10.2196/humanfactors.5083", url="http://humanfactors.jmir.org/2016/2/e21/", url="http://www.ncbi.nlm.nih.gov/pubmed/27528543" } @Article{info:doi/10.2196/humanfactors.4361, author="Orlowski, Kate Simone and Lawn, Sharon and Venning, Anthony and Winsall, Megan and Jones, M. Gabrielle and Wyld, Kaisha and Damarell, A. Raechel and Antezana, Gaston and Schrader, Geoffrey and Smith, David and Collin, Philippa and Bidargaddi, Niranjan", title="Participatory Research as One Piece of the Puzzle: A Systematic Review of Consumer Involvement in Design of Technology-Based Youth Mental Health and Well-Being Interventions", journal="JMIR Human Factors", year="2015", month="Jul", day="09", volume="2", number="2", pages="e12", keywords="mental health", keywords="young people", keywords="technology", keywords="intervention", keywords="participatory", keywords="design", abstract="Background: Despite the potential of technology-based mental health interventions for young people, limited uptake and/or adherence is a significant challenge. It is thought that involving young people in the development and delivery of services designed for them leads to better engagement. Further research is required to understand the role of participatory approaches in design of technology-based mental health and well-being interventions for youth. Objective: To investigate consumer involvement processes and associated outcomes from studies using participatory methods in development of technology-based mental health and well-being interventions for youth. Methods: Fifteen electronic databases, using both resource-specific subject headings and text words, were searched describing 2 broad concepts-participatory research and mental health/illness. Grey literature was accessed via Google Advanced search, and relevant conference Web sites and reference lists were also searched. A first screening of titles/abstracts eliminated irrelevant citations and documents. The remaining citations were screened by a second reviewer. Full text articles were double screened. All projects employing participatory research processes in development and/or design of (ICT/digital) technology-based youth mental health and well-being interventions were included. No date restrictions were applied; English language only. Data on consumer involvement, research and design process, and outcomes were extracted via framework analysis. Results: A total of 6210 studies were reviewed, 38 full articles retrieved, and 17 included in this study. It was found that consumer participation was predominantly consultative and consumerist in nature and involved design specification and intervention development, and usability/pilot testing. Sustainable participation was difficult to achieve. Projects reported clear dichotomies around designer/researcher and consumer assumptions of effective and acceptable interventions. It was not possible to determine the impact of participatory research on intervention effectiveness due to lack of outcome data. Planning for or having pre-existing implementation sites assisted implementation. The review also revealed a lack of theory-based design and process evaluation. Conclusions: Consumer consultations helped shape intervention design. However, with little evidence of outcomes and a lack of implementation following piloting, the value of participatory research remains unclear. ", doi="10.2196/humanfactors.4361", url="http://humanfactors.jmir.org/2015/2/e12/", url="http://www.ncbi.nlm.nih.gov/pubmed/27025279" }