JMIR Publications

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  User-Centered Design Case Studies

  Feb 13, 2026

  Overview of a User-Centered, Mixed-Methods Process for Designing Interconnected and Focused Mobile Applications on Patient Care Environment (InterFACE):...

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  Authors List:

  • Frederic Ehrler  
  • Ana Rajic  
  • Alexandre De Masi  
  • Sharleen Olanka  
  • Marco Generelli  
  • Jennifer Davidson  
  • Yiqun Lin  
  • Kangsoo Kim  
  • Pierre-Louis Rebours  
  • Marc Ibrahim  
  • Donovan Duncan  
  • Ryan Kang  
  • Sergio Manzano  
  • Adam Cheng  
  • Johan N Siebert  

  Abstract:

  Background: Pediatric cardiopulmonary resuscitation (CPR) is a highly complex and time-critical process that demands precise team coordination and strict adherence to Pediatric Advanced Life Support (PALS) guidelines. In real-world practice, adherence often deteriorates due to cognitive overload, fragmented communication, and disruption of information flow under stress. Although digital cognitive aids have shown potential to improve adherence, existing tools are often limited to single tasks, lack team-wide integration, or fail to adapt in real time to dynamic clinical environments. Objective: This study aimed to design and evaluate InterFACE (Interconnected and Focused Mobile Applications on Patient Care Environment), an integrated, augmented reality (AR)–enabled digital health system developed to support real-time PALS adherence and enhance team coordination during pediatric resuscitation. Methods: A structured, mixed-methods, user-centered design process was employed. Persona development and spatial analysis characterized the needs and positions of key resuscitation roles. A three-round Delphi process with experts identified critical information elements for display. Iterative user experience (UX) prototyping was performed, followed by simulation-based evaluations of three system components: (1) TeamScreen, a wall-mounted team display providing a shared overview of the resuscitation process; (2) Guiding Pad, a tablet-based app for documentation and algorithm navigation; and (3) AR head-mounted displays (HMDs) for team leaders and medication nurses, delivering role-specific, context-aware guidance. Usability was assessed with standardized instruments, including the System Usability Scale (SUS), Technology Acceptance Model (TAM), and User Experience Questionnaire (UEQ). Results: The Delphi study achieved consensus on 20 core information elements, distributed across the three interfaces. Usability testing demonstrated high acceptance across all modalities. The Guiding Pad supported effective navigation of resuscitation algorithms with a 78–100% task completion rate. The TeamScreen achieved an overall task success rate of 81%, improving situational awareness despite some confusion in high-density regions. AR HMDs received favorable evaluations, with SUS scores rated “Good” to “Excellent,” and UEQ ratings indicating high intuitiveness, stimulation, and attractiveness. Participants consistently described InterFACE as intuitive, useful for real-time decision-making, and supportive of team synchronization. Reported challenges included interface complexity, incomplete integration with patient monitors, and potential cognitive load from simultaneous information streams. Conclusions: InterFACE represents a significant advancement in digital cognitive aids by combining shared displays, tablets, and AR guidance into a synchronized, role-specific ecosystem. The system shows promise in enhancing adherence to PALS, reducing cognitive load, and improving team coordination in simulated pediatric resuscitations. While results demonstrate strong usability and acceptance, further research is needed to evaluate clinical effectiveness in real-world settings, including randomized controlled trials, integration with hospital information systems via FHIR standards, and potential AI-driven decision support to optimize adaptability and long-term skill retention.

  • JMIR Hum Factors 2026;13(1):e78144

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  Design and Usability of Websites for...

  Feb 12, 2026

  Adolescent Perceptions of an Online Safety Chatbot: Survey Study

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  Authors List:

  • Meriel Charles  
  • James D Sauer  
  • Erin Roehrer  
  • Jeremy Prichard  
  • Paul Watters  
  • Joel Scanlan  

  Abstract:

  Background: Adolescents face a variety of potential harms in the online environment, including exposure to distressing illegal material, cyberbullying, image-based abuse, and “sextortion.” Various agencies provide on-demand helpline and information services for children and adolescents to support them with navigating online (and offline) harms. Objective: This study examined whether a chat-based conversational agent (chatbot) might be a useful additional tool for meeting the needs of adolescents at risk from online harms. We developed a prototype chatbot—including both conversational and menu-driven user options—and evaluated users’ trust in the chatbot. In this context, trust relates to perceptions of the chatbot’s usability and the value of the information and support it provides. Methods: Participants (n=224; mean age 16.8 years) interacted with the chatbots and evaluated them in terms of user trust: perceived usability and utility (ie, relevance of support resources provided). Results: Most participants (conversational chatbot: 141/224, 63% and menu-driven chatbot: 142/224, 63%) showed a willingness to click on the chatbots’ recommended support links. Participants with higher trust in the chatbots were more likely to click the links for recommended support services (with extreme evidence for large effects: δ=0.73, 95% credible interval [CrI] 0.46-1.00 and δ=0.78, 95% CrI 0.50-1.07, for the conversational and menu-driven chatbots, respectively; Bayes factor [BF₁₀]>50,000), and participants who clicked the links, compared with those who did not, reported higher rates of positive attitudes toward their decision (with extreme evidence for large effects: δ=0.87, 95% CrI 0.58-1.15 and δ=0.84, 95% CrI 0.54-1.12, for the conversational and menu-driven chatbots, respectively; BF₁₀>3,000,000). The conversational and menu-driven chatbots differed little in perceived trust or effectiveness. Conclusions: Chatbots represent a promising additional tool to help adolescents access mental health–related support services and navigate online harms. However, establishing trust is critical.

  • JMIR Hum Factors 2026;13(1):e71498

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  Reviews on Human Factors

  Feb 12, 2026

  Physical and Psychological Effects of Smartphone App–Based Walking Interventions in Community-Dwelling Older Adults: Systematic Review and Behavior Change...

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  Authors List:

  • Hiroki Abe  
  • Tomohiro Isinuki  
  • Rinako Ono  
  • Naoki Kanaya  
  • Masaya Tanno  
  • Michiyo Hirano  

  Abstract:

  Background: With the global increase in population aging, promoting walking as a health behavior to maintain and enhance well-being among older adults has become increasingly important. In recent years, advances in information and communication technology (ICT) and mobile health (mHealth) have supported the development of health interventions delivered through smartphone applications (apps). However, no review to date has included psychological aspects such as motivation or intention to walk, and the behavior change techniques (BCTs) embedded in smartphone apps that effectively promote walking remain unclear. Objective: This study had two primary aims: first, to evaluate the effects of smartphone app use on walking behavior and intention to walk among community-dwelling older adults; and second, to identify the specific behavior change techniques delivered through these apps that may promote walking behavior and intention effectively. Methods: Eligible studies were those published in English or Japanese between March 1, 2015, and February 28, 2025, that focused on community-dwelling older adults, implemented smartphone app-based interventions, and reported walking-related outcomes. A systematic search strategy was designed using keywords such as “older,” “smartphone,” and “walking.” Risk of bias was evaluated using the Study Quality Assessment Tools. The features of the apps described in the selected studies were examined to identify the BCTs they employed, as categorized by the BCT Taxonomy. Results: Of the 296 studies initially retrieved, eight met the inclusion criteria. These studies vary in terms of participant characteristics, intervention duration, app features, and outcomes, and most were pilot studies. While several apps were designed specifically to increase walking, others included features that facilitated social interaction among users. In addition, two studies also reported improved motivation to walk. Apps that were associated with statistically significant improvements in walking behavior frequently employed BCTs from the following clusters: (1) Goals and Planning, (2) Feedback and Monitoring, and (4) Shaping Knowledge. Notably, five BCTs were not incorporated into any of the reviewed apps. Conclusions: Although smartphone apps have the potential to improve walking behavior and intention among community-dwelling older adults, the current body of evidence remains limited. Apps that deliver walking-related knowledge, facilitate goal setting, and support behavioral monitoring appear especially effective and may strengthen walking behavior and intention in this population.

  • JMIR Hum Factors 2026;13(1):e78042

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  Methods in Human Factors Research

  Feb 11, 2026

  Interest in and Predictors of Engagement With a Virtual Reality Intervention Among People With Chronic Pain: Cross-Sectional Survey Study

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  Authors List:

  • Genevieve R Bryant  
  • Samuel A Holzman  
  • Hector R Perez  

  Abstract:

  Background: Although chronic pain (CP) is highly prevalent, current modalities are not sufficient to address the needs of people living with this condition. Pharmacological treatments for CP can have severe side effects and increased likelihood of patients overdosing or developing addiction. Behavioral treatments are often indicated for the treatment of CP, but barriers to treatment are common. Virtual reality (VR)–based interventions have shown promise as an effective and potentially accessible form of treatment for CP. However, previous research on VR interventions for people living with CP has not often included diverse populations, including racial and ethnic minority groups and people with low socioeconomic status. Objective: This study aimed to gauge the interest of patients with CP in participating in a hypothetical study of at-home VR for CP and to identify predictors of interest. Patients were recruited from a low socioeconomic and racially and ethnically diverse community. Methods: A total of 48 participants living with CP were recruited from an electronic medical record database, a research participant database, and a pain clinic, and they completed surveys about demographics, pain levels, technology use, and knowledge of VR. Bivariate testing was used to determine which, if any, of the aforementioned variables were associated with interest in a hypothetical study of at-home VR for CP. Stepwise logistic regression models predicting interest were built based on bivariate testing. Finally, we used a thematic analysis framework to analyze an additional open-ended question about reasons for interest in participating in a VR intervention for CP. Results: Despite low technology use and little knowledge and experience with VR, results showed high interest (42/48, 88%) among patients in participating in a hypothetical study of at-home VR for CP. More frequent email use and using Facebook demonstrated nonsignificant trends toward interest in participating in a VR clinical trial for pain (P=.06 for email use and P=.06 for Facebook use). In stepwise multivariate models controlling for pain score, Facebook use was predictive of being somewhat or very interested in participating in a VR clinical trial for pain (P=.047). Open-ended responses tended to cite the novelty of VR and desperation for pain relief as reasons for participants’ interest. Conclusions: We found high interest in participating in a clinical trial of VR despite low use of technology and low knowledge of VR. Future fully powered studies should seek to confirm the effectiveness of VR treatments for people with CP, especially people from lower socioeconomic, and racially and ethnically diverse backgrounds.

  • JMIR Hum Factors 2026;13(1):e70598

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  Psychological, Behavioral, Social,...

  Feb 11, 2026

  Mental Health Profiles Based on Self-Regulation and Technology Use in the Digital Era in a Spanish-Speaking Sample: Latent Profile Analysis

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  Authors List:

  • Angélica Garzón Umerenkova  
  • Marisleidy Alba Cabañas  
  • Erika Andrea Malpica-Chavarria  

  Abstract:

  Background: The widespread use of digital technologies has raised growing concerns about their impact on mental health. While self-regulation has been proposed as a protective factor, little is known about how distinct psychological profiles based on self-regulatory and technology use patterns relate to psychological distress. Person-centered approaches such as Latent Profile Analysis may offer deeper insights, particularly in underrepresented populations. Objective: This study aimed to identify latent psychological profiles based on self-regulation, nomophobia (fear of being without a phone), and problematic use of the internet and social media (defined by behavioral symptoms), to examine their association with general psychological distress and the presence of emotional symptoms in a Colombian sample. Additionally, the predictive roles of age and gender on class membership were explored. Methods: Participants were recruited through a convenience sampling strategy aimed at ensuring heterogeneity of the sample in terms of age and gender. 453 participants aged 12 to 57 years (M = 21.03, SD = 8.41; 57% female) completed validated measures of self-regulation (Self-Regulation Questionnaire, CAR Abrev.), nomophobia (Nomophobia Questionnaire, NMP-Q), internet and social media use (MULTICAGE-TIC), and psychological distress (General Health Questionnaire, GHQ-12). Latent Profile Analysis was conducted using standardized scores of continuous variables. Model fit was assessed using Bayesian Information Criterion (BIC), entropy, and Bootstrap Likelihood Ratio Test (BLRT). Differences in psychological distress scores across latent classes were examined through variance analysis (ANOVA) and regression models. A multinomial logistic regression tested the predictive value of age and gender on class membership. Results: The optimal solution revealed four distinct latent profiles (entropy = 0.85): Class 1 showed high self-regulation and low problematic technology use, displaying the lowest psychological distress scores. Class 2 presented moderate levels across all indicators, but the highest levels of psychological distress. Classes 3 and 4 showed mixed patterns: Class 3 (higher ICT use and lower self-regulation) exhibited lower distress than Class 2, whereas Class 4 (younger individuals with low self-regulation and moderately high ICT use) showed higher distress than Class 3. Psychological distress differed significantly across profiles (ANOVA, p < .001). Age and gender predicted class membership: older males were more likely to belong to Class 1, and younger females were more likely to be classified into Classes 3 and 4. Conclusions: Latent Profile Analysis identified distinct configurations of digital behavior, self-regulation, and psychological distress. Self-regulation consistently differentiated profiles with lower distress scores, suggesting its relevance for understanding how individuals manage ICT use. These findings support the value of person-centered approaches to characterize heterogeneous patterns of technology-related behaviors. The study provides evidence from a Spanish-speaking sample, offering a novel perspective on psychological distress and problematic technology use in contexts that remain underrepresented in the literature.

  • JMIR Hum Factors 2026;13(1):e77167

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  Usability Evaluation Case Studies

  Feb 9, 2026

  Quality of Informed Consent and Interface Usability in Primary Care e-Consultation: Cross-Sectional Study

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  Authors List:

  • Curtis Parfitt-Ford  
  • Lisa Ballard  
  • Adriane Chapman  

  Abstract:

  Background: Patient autonomy through informed consent is a foundational ethical principle for health care practitioners. Online consent processes risk producing “consent in name only,” using manipulative or confusing user interfaces to extract consent artificially. This presents a significant danger for safe and ethical remote consultations for primary care providers, which often extract significant amounts of sensitive personal data. Objective: This study aims to examine the quality of consent obtained through both currently used and novel consent acquisition interfaces for remote e-consultations between a patient and a primary care provider. Methods: A total of 55 adult participants in the United Kingdom completed an interaction with a mock-up e-consultation system’s consent interface for data processing, with 54 completing the full study protocol. The participants were then asked questions regarding what they had provided consent for and the usability of the interface. These responses led to the calculation of an industry-standard System Usability Scale (SUS) score and a novel Quality of Informed Consent Collected Digitally (QuICCDig) score. Results: Users perceiving interfaces to be more usable (with a greater SUS score) were statistically significantly (n=54; P=.004) correlated with an increase in the quality of consent collected from those users (with a higher QuICCDig score). Nonetheless, both existing and novel user interfaces for collecting e-consultation consent were rated poorly, achieving a maximum SUS letter grade of “F.” In total, 45% (25/55) of all the participants reported not recalling making a privacy-related decision at all during their consultation, and 87% (48/55) did not recall being offered any alternatives to e-consultation. Conclusions: The findings demonstrate that current methods for collecting consent in telemedical applications may not be fit for purpose and potentially fail to collect valid informed consent. However, increased usability scores from users do appear to drive improvements in the quality of consent collected. Therefore, decision-makers should place importance on high-quality interface design when building or procuring these systems. We have also provided the QuICCDig score for further use.

  • JMIR Hum Factors 2026;13(1):e78483

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  Focus Groups and Qualitative Research...

  Feb 9, 2026

  Evaluation of the Implementation of a Mobile Health App to Support Dutch Primary Care for Diabetes: Qualitative Study

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  Authors List:

  • Liselot N van den Berg  
  • Lisenka te Lindert  
  • Jiska J Aardoom  
  • Anke Versluis  
  • Sofie H Willems  
  • Niels H Chavannes  
  • Marise J Kasteleyn  

  Abstract:

  Background: Over 1 million Dutch people have diabetes, of whom 90% have type 2 diabetes. Studies show that lifestyle plays an important role in the course of type 2 diabetes. MiGuide (MiGuide Ltd) is an online platform that helps people adopt and sustain lifestyle changes. The platform is integrated into existing diabetes care within primary care. Previous research has shown that implementing new (eHealth) interventions is challenging and may reduce effectiveness. Mapping out the barriers and success factors in the implementation process is essential so that eHealth interventions such as MiGuide can be used effectively in regular health care. Objective: This study aimed to evaluate the implementation of MiGuide within Dutch primary care. Methods: A qualitative study design was used, supplemented by quantitative data from patients. Five general practices participated. Three focus groups (FGs; at baseline, after 6 months, and after 12 months) were conducted with 3 general practitioners, 3 FGs with 8 specialized practice nurses (divided into 2 separate groups with 4 participants per group), 2 FGs (at 6 months and after 12 months) with 5 patients, and 2 FGs (at baseline and after 12 months) with 4 stakeholders from the management of the care group. The implementation process was discussed with health care professionals and management, and usage and user-friendliness were discussed with patients. The framework method was used to analyze the data. The following quantitative data were collected: patient characteristics, user data, and questionnaires at baseline and 6 months, assessing quality of life, usability, and diabetes self-care. The quantitative data were examined using exploratory analyses. Results: Four themes were found in the qualitative data: “innovation,” “capability, motivation, and opportunity,” “processes,” and “setting.” Different factors within these themes played an essential role throughout the implementation process, such as facilities, technical difficulties, motivation, COVID-19, and the work processes. Areas for improvement were also identified. The supplemented quantitative data showed that usability scored below average at 6 months (mean 53.8; SD 9.3; n=8). Participants had a mean score of 0.84 (SD 0.13) on the EuroQoL-5 dimension and 81.9 (SD 13.4) on the EuroQoL visual analogue scale at baseline. Moreover, the average number of days someone exercised was 4.2 (SD 1.7), and the number of days someone ate a generally healthy diet was 5.1 (SD 1.3). Insufficient data on quality of life and diabetes self-care were collected at 6 months and therefore not presented in this study. Conclusions: Implementation is a complex process with multiple barriers and facilitators. It is essential to explore the use of context-specific strategies that are aligned with the implementation process phase. Further research is needed to evaluate the next version of the MiGuide platform, which is being implemented in another setting with lifestyle coaches.

  • JMIR Hum Factors 2026;13(1):e54431

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  Attitudes, Beliefs, and Health...

  Feb 9, 2026

  Sex Representation and User Preferences in Pain Drawing Body Charts in Back Pain Research: Multimethod Study

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  Authors List:

  • Sonja Schläpfer  
  • Casey Murphy  
  • Yanick X Lukic  
  • Concepción Campos-Asensio  
  • Giovanni Colacicco  
  • Beatrice A Lauber  
  • Sophie Masneuf  
  • Luana Nyirö  
  • Georg W Kajdi  
  • Reto Sutter  
  • Christoph J Laux  
  • Philipp Ackermann  
  • Jesús López-Alcalde  
  • Claudia M Witt  

  Abstract:

  Background: Pain drawing (PD) body charts are widely used in back pain research, but the representation of sex in these charts has not been systematically evaluated. Objective: To evaluate sex representation in PD body charts used in back pain research, assess the perception of a newly designed sex-neutral body chart, and explore user preferences for sex representation in PD body charts. Methods: We conducted a multi-method study comprising: (1) a scoping review to assess sex representation and the reporting of sex in PD body charts in back pain literature; (2) an expert opinion study where anatomy experts evaluated the perceived sex of extracted body charts; and (3) a survey among a representative sample of UK adults with and without back pain to assess perception of a newly designed sex-neutral body chart and explore preferences for sex representation in PD body charts. Results: From 349 full-text papers, 108 articles met inclusion criteria. Most (103/108; 95.37%) did not report the sex of body charts used, and only 5.56% (6/108) included both male and female charts. Experts showed fair to moderate agreement (Fleiss’ kappa = 0.306; Gwet’s AC1 = 0.456) in assessing the sex of charts, with most charts assessed as male based on majority ratings (59/108, 54.63%) and classified as male-biased relative to the sex distribution of study participants (76/108, 67.65%). The newly designed sex-neutral body chart was perceived as sex-neutral by 68.5% (204/298) of survey participants across diverse groups. However, perceptions varied by racial group: 73.00% (181/248) of White participants viewed it as sex-neutral, compared to 42.50% (17/40) of participants from smaller racial groups (χ² = 15.88, p = 0.001). Female participants slightly preferred female charts (85/154; 55.19%); males preferred sex-neutral ones (88/144; 61.11%). Nonetheless, most participants (53.25% (82/154) of females, 74.31% (107/144) of males) considered the option to choose between male, female, and sex-neutral chart versions unimportant. Conclusions: Our study reveals reporting gaps and a predominant male bias in the representation of sex in PD body charts used in back pain research. The newly developed sex-neutral body chart was widely perceived as sex-neutral, offering a promising step toward more inclusive pain assessment. However, variations in perception across racial groups highlight the need for cultural considerations in design. These findings underscore the potential of sex-neutral and culturally sensitive body charts to enhance the inclusivity and equity of back pain research and clinical practice. Clinical Trial: OSF (https://osf.io/pbuch/)

  • JMIR Hum Factors 2026;13(1):e76175

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  Design and Usability of Medical Devices

  Feb 6, 2026

  Opportunities for Improved Device Design Based on Central Line Placement Practices: Contextual Inquiry Study

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  Authors List:

  • Mary Beth Privitera  
  • Sameer Khan  
  • Bilal Irfan  
  • Shayan Ali  
  • Cecelia Arredondo  
  • Kyrsten Sanderson  
  • Jordan Bonomo  

  Abstract:

  Background: Central venous catheters (CVCs) are indispensable to contemporary critical care, perioperative management, and emergency resuscitation, yet their insertion remains fraught with preventable harm and inefficiency. Objective: This study aimed to identify all areas of CVC placement that can be improved through device design using human-centered design and qualitative research methods. Methods: This qualitative study was a contextual inquiry of CVC placement, which included observation alongside brief face-to-face interviews with physicians. It was aimed at providing a depth of understanding using evidence to demonstrate causality. This study was conducted at 3 hospitals in the emergency department, the intensive care unit, and the operating rooms. Where possible and with additional consent, sessions were recorded in video or still photography, or at times both. This study included 19 observations and 24 interviews. Results: In this study, the approach to CVC insertion was consistent across hospitals and care environments, with moderate variability spanning a few sections, such as suture and dressing use or lack thereof in specific care environments. The described and observed difficulties leave room for improvement in device design. The results of this study indicated that there are 34 discrete steps to placing a CVC line, with most time spent during sterile preparation. As a result of the device or kit design, challenges were observed. These included missing essential materials from kits, difficulty distinguishing between nonsterile and sterile items, challenges with lidocaine ampules, patient claustrophobia from draping, and a lack of user preference for kit contents. Additional challenges included obscured ultrasound views, kinked guidewires, overall procedural untidiness, and considerable waste management issues. Conclusions: An intuitive kit that aligns with predictable human behavior and eliminates unnecessary multistep detours can reduce novice failure rates, cognitive load, and practice inconsistency, and it could also curb nonrecyclable waste from “backup” kits opened for a single missing item. By reframing CVC systems as sociotechnical solutions rather than static assortments of parts, the same design moves that minimize improvisation and coordination errors for physicians may also reduce dwell time and manipulation events for patients, thereby advancing the core triad of safety, procedural efficacy, and everyday usability. By examining how clinicians place central lines, this study reveals modifiable design flaws that perpetuate risk despite decades of procedural standardization. Contextual inquiry provides the evidentiary bridge between clinical imperatives to reduce complications and the practical realities of device use. Embedding such investigations at the outset of design and iteratively throughout product life cycles offers a path toward safer, more efficient, and more humane central venous access for both patients and providers.

  • JMIR Hum Factors 2026;13(1):e84621

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  User-Centered Design Case Studies

  Feb 6, 2026

  Development of the ERATbi App, a Clinical Decision Support System for Early Recovery After Traumatic Brain Injury in the ICU: Usability Study

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  Authors List:

  • Hsiao-Ching Yen  
  • I-Hui Wu  
  • Wei-Ling Hsiao  
  • Sheng-Ru Lai  
  • Chen-Hao Yang  
  • Hsien-Chi Liao  
  • Yin-Yi Han  

  Abstract:

  Background: Early rehabilitation in neurocritical care is frequently underutilized due to fragmented workflows, interdisciplinary coordination challenges, and a lack of structured digital decision support. Traditional clinical decision support systems (CDSS) often address single domains and do not accommodate the dynamic and multi-professional nature of ICU environments. Objective: This study aimed to design and evaluate the usability of the ERATbi App, a modular, tablet-based CDSS developed to support early rehabilitation planning for patients with moderate-to-severe traumatic brain injury (TBI) in intensive care settings. Methods: The ERATbi App integrates four functional modules—delirium risk management, precision nutrition, stepwise early mobilization, and respiratory care for rib fractures—into a unified interface. A simulation-based usability study was conducted with 18 ICU clinicians. Metrics included System Usability Scale (SUS) scores, task completion rates, error rates, and task durations. Additional feedback was gathered via a 5-point Likert satisfaction scale and open-ended responses. Results: The app demonstrated high usability (mean SUS = 83.6 ± 7.4), 100% task completion, and a low error rate (4.2%). Average module completion time was 6.5 minutes, and participants reported strong satisfaction (mean = 4.7 ± 0.5). Users highlighted the value of the app’s visual logic, real-time alerts, adaptive thresholds, and modular workflow integration for enhancing team coordination and decision consistency. Conclusions: The ERATbi App exhibited strong usability, high user satisfaction, and clinical relevance in simulated ICU workflows. Its logic-driven, workflow-embedded design may support scalable, interdisciplinary implementation of early rehabilitation in neurocritical care environments. Clinical Trial: Not applicable (this study does not meet the WHO definition of a clinical trial)

  • JMIR Hum Factors 2026;13(1):e79981

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  Methods in Human Factors Research

  Feb 3, 2026

  Expert Views on Criteria for Evaluation of Human Factors Methods: Qualitative Interview Study

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  Authors List:

  • Selvana Awad  
  • Rachel Begg  
  • Thomas Loveday  
  • Andrew Baillie  
  • Melissa Baysari  

  Abstract:

  Background: Human factors (HF) or ergonomics, which explores the interaction between humans and systems, has been used to support design in safety critical industries such as aviation, transportation, nuclear power and manufacturing. HF methods have the potential to support the safe design of health information technology (HIT) however the evaluation of HF methods to determine their effectiveness and feasibility in this context has been limited. Objective: The aim of this study was to identify criteria for evaluating HF methods when applied to real world projects and use these to propose a framework for method evaluation. Methods: HF practitioners were recruited via a purposive sampling method in conjunction with snowball sampling and invited to participate in a semi-structured interview to discuss HF methods and how they should be evaluated. Results were reviewed and thematically analysed. Results: A total of 21 participants took part, and interviews lasted on average 52 minutes (range 39 – 103 minutes). Participants explained that they did not routinely evaluate methods, however they outlined a range of criteria to support method evaluation. Overall, 5 criteria and 28 sub-criteria were identified. High level criteria included effectiveness, efficiency, ease of use and acceptability, and impact on the solution. Conclusions: Results from this study have been used to propose a framework for evaluating HF methods used in real world HIT projects. The framework could provide organisations with valuable information on how to optimise the application and outcomes of HF methods, and build HF capability within organisations particularly where this may be lacking. Clinical Trial: N/A

  • JMIR Hum Factors 2026;13(1):e73324

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  Design and Usability of Websites for...

  Feb 2, 2026

  Navigation, Adoption, and Use of Digital Health Technologies for Irritable Bowel Syndrome Self-Management: Focus Group Study of Patient Experience and...

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  Authors List:

  • Adrijana D'Silva  
  • Nicolle Hua  
  • Mary V Modayil  
  • Judy Seidel  
  • Deborah A Marshall  

  Abstract:

  Background: Irritable bowel syndrome (IBS) is a common chronic gastrointestinal disorder that impairs bowel functions and patients’ overall quality of life. IBS-focused digital health technologies (DHTs), including online health resources and mobile health (mHealth) apps, have recently proliferated for patient use. However, research exploring patients’ experiences with navigating, adopting, or using commercial or publicly available DHTs for IBS self-management is limited. Objective: This study aims to explore the user experiences and decision-making of patients with IBS as they navigate, adopt, and use diverse DHTs for disease self-management. Methods: We conducted virtual semistructured focus group interviews to explore the experiences of patients with IBS using DHTs, including their perspectives on design and features, their decision-making process in using DHTs, and recommendations for improving user experience and uptake, given the heterogeneous nature of these tools. Canada-based patients with IBS who were using or had used mHealth apps to manage symptoms were recruited through purposive sampling from previous IBS-related studies. Discussions were transcribed verbatim, and inductive thematic analysis was performed using NVivo (version 14; Lumivero). A modified version of the Expanded Unified Theory of Acceptance and Use of Technology (UTAUT2) model was applied to guide the interpretation of the dynamic relationship between the influences on participants’ decisions regarding DHT use. Results: Among the 8 participants (all female; mean age 55.3, SD 13.5 years), two themes were identified: (1) uncertainty impacts the trustworthiness of DHTs, and (2) influences that drive the decision-making process to adopt and use DHTs. The observed influences aligned with the constructs of the UTAUT2 model (performance expectancy, effort expectancy, social influence, facilitating conditions, hedonic motivation, price value, and habit), with the addition of trust and risk in participants’ decision-making. Digital health literacy and patient engagement were also raised as crucial components of participants’ experiences and perspectives on DHTs. Conclusions: Findings of this study highlight the current landscape of digital health in IBS and existing gaps and challenges for patients in navigating, adopting, and using DHTs for IBS self-management. While DHTs were generally viewed positively for their value and potential, patients with IBS consider several coexisting factors and trade-offs in their decision-making. Further investigations on the influences on and perspectives toward DHTs could enhance future development and iterations of these tools and improve patient confidence and uptake.

  • JMIR Hum Factors 2026;13(1):e75012

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