Psychophysiological insights and user perspectives: enhancing police de-escalation skills through full-body VR training.

In recent years, Virtual Reality (VR) has emerged as a promising tool for enhancing training responses in high-stress professions, notably among police officers. This study investigates the psychophysiological responses and subjective user experience of active police officers undergoing Mental Health Crisis Response (MHCR) training using an immersive full-body VR system. A total of 10 active police officers with Special Weapons and Tactics (SWAT) training participated in our controlled study. Officers independently took part in one VR training session lasting 7-12 min involving an avatar in crisis portrayed by an actor. Officers wore integrated cardiovascular and electrodermal activity measurement devices for physiological monitoring. VR user experience aspects such as induced symptoms or game mechanics were investigated upon completing the training, aiming to evaluate the officer's perceptions of the technology. We used the DePICT™ scale to evaluate the de-escalation skills of officers, coded by a research professional. Our findings revealed significant differences in heart rate and heart rate variability responses between baseline and VR scenario immersion, suggesting heightened stress regulation during the MHCR simulation using full-body VR. Arousal measurements also revealed measurable responses during the training in VR. Additionally, the user experience assessment indicated a positive reception to the VR training, with minimal VR-induced symptoms. A "Defensive-Dynamics-Dichotomy" was revealed highlighting dominant autonomic responses linked to defensive actions (e.g., officers who drew a weapon; those who kept their weapons holstered) and their respective implications for stress management and cognitive function. A unique constellation of de-escalation skills was revealed among officers who relied on weapons relative to those who did not, to resolve the scenario. The study highlighted the perceived utility of physiological monitoring technologies in enhancing police training outcomes. In conclusion, our research underscores the potential of VR as an effective tool for de-escalation training following MHCR simulated scenarios among active police officers, offering insights into its psychophysiological impact and user experience. The findings contribute to improving our understanding of the physiology associated with decision-making in police officers to draw a weapon, emphasizing the role of advanced simulation and physiological monitoring technology in developing evidence-based training programs for public safety.

User Experience of a Large-Scale Smartphone-Based Observational Study in Multiple Sclerosis: Global, Open-Access, Digital-Only Study.

BACKGROUND: The Floodlight Open app is a digital health technology tool (DHTT) that comprises remote, smartphone sensor-based tests (daily activities) for assessing symptoms of multiple sclerosis (MS). User acquisition, engagement, and retention remain a barrier to successfully deploying such tools. OBJECTIVE: This study aims to quantitatively and qualitatively investigate key user experience (UX) factors associated with the Floodlight Open app. METHODS: Floodlight Open is a global, open-access, digital-only study designed to understand the drivers and barriers in deploying a DHTT in a naturalistic setting without supervision and onboarding by a clinician. Daily activities included tests assessing cognition (Information Processing Speed and Information Processing Speed Digit-Digit), hand-motor function (Pinching Test and Draw a Shape Test), and postural stability and gait (Static Balance Test, U-Turn Test, and Two-Minute Walk Test [2MWT]). All daily activities except the 2MWT were taken in a fixed sequence. Qualitative UX was studied through semistructured interviews in a substudy of US participants with MS. The quantitative UX analysis investigated the impact of new UX design features on user engagement and retention in US participants for 3 separate test series: all daily activities included in the fixed sequence (DA), all daily activities included in the fixed sequence except the Static Balance Test and U-Turn Test (DAx), and the 2MWT. RESULTS: The qualitative UX substudy (N=22) revealed the need for 2 new UX design features: a more seamless user journey during the activation process that eliminates the requirement of switching back and forth between the app and the email that the participants received upon registration, and configurable reminders and push notifications to help plan and remind the participants to complete their daily activities. Both UX design features were assessed in the quantitative UX analysis. Introducing the more seamless user journey (original user journey: n=608; more seamless user journey: n=481) improved the conversion rate of participants who enrolled in the study and proceeded to successfully activate the app from 53.9% (328/608) to 74.6% (359/481). Introducing reminders and push notifications (with reminders and notifications: n=350; without reminders and notifications: n=172) improved continuous usage time (proportion of participants with ≥3 consecutive days of usage: DA and DAx: ~30% vs ~12%; 2MWT: ~30% vs ~20%); test completion rates (maximum number of test series completed: DA: 279 vs 64; DAx: 283 vs 126; 2MWT: 302 vs 76); and user retention rates (at day 30: DA: 53/172, 30.8% vs 34/350, 9.7%; DAx: 53/172, 30.8% vs 60/350, 17.1%; 2MWT: 39/172, 22.6% vs 22/350, 6.2%). Inactivity times remained comparable. CONCLUSIONS: The remote assessment of MS with DHTTs is a relatively nascent but growing field of research. The continued assessment and improvement of UX design features can play a crucial role in the successful long-term adoption of new DHTTs.

Feasibility and Acceptability Study of a Culturally Adapted Web-Based Intervention to Reduce Suicidal Ideation for Syrian Asylum Seekers and Refugees in the United Kingdom: Protocol for a Mixed Methods Study.

BACKGROUND: The war in Syria has displaced over 6.8 million people, more than any other conflict since the Second World War. As a result, Syrian asylum seekers and refugees have experienced several life-changing events, resulting in high rates of anxiety, depression, posttraumatic stress disorder, and suicidal ideation (SI). To address the treatment gap and reduce the burden of help-seeking, a web-based intervention to reduce SI developed for general populations was culturally adapted for and with Syrian asylum seekers and refugees in the United Kingdom. The study revealed the importance of understanding their lived experience with migration and the acculturative process in providing treatment for SI. This study will now assess the feasibility and acceptability of the culturally adapted intervention for this population. OBJECTIVE: The first phase of the study will include recruiting participants and delivering the web-based intervention (1) to assess the feasibility of meeting recruitment goals and recruitment rates and (2) to assess the feasibility of outcome measures. The second phase of the study will include one-to-one semistructured interviews (1) to assess the suitability of the culturally adapted intervention in terms of recruitment and adherence rates and barriers and facilitators to engagement and (2) to assess the acceptability of the intervention in terms of its cultural relevance and appropriateness. METHODS: This is a protocol for a single-group, noncontrolled, mixed methods feasibility and acceptability study of a culturally adapted web-based intervention to reduce SI for Syrian asylum seekers and refugees in the United Kingdom. The study will assess the feasibility of recruitment goals, recruitment rates, adherence rates, and outcome measures using individual participant tracking forms, which will be analyzed quantitatively. The suitability and acceptability of the intervention will be assessed using one-to-one semistructured interviews with 12 participants who completed the intervention, which will be analyzed qualitatively. RESULTS: Recruitment began in February 2024 and will run until 30 participants are recruited to the study or until the end of July 2024. Thus far, 19 participants have provided informed consent, 16 were eligible and enrolled, and 12 have completed a postintervention interview. No data have been analyzed. The study, including the write-up period, is expected to end in December 2024. CONCLUSIONS: Despite experiencing several stressors related to forced displacement and high rates of mental health issues, access to treatment is still limited for Syrian asylum seekers and refugees in the United Kingdom. To address the treatment gap and reduce the burden of help-seeking, a web-based intervention to reduce SI was culturally adapted in collaboration with Syrian asylum seekers and refugees in the United Kingdom. This study will now assess the feasibility and acceptability of the intervention and culturally appropriate recruitment strategies. TRIAL REGISTRATION: ISRCTN ISRCTN11417025; https://www.isrctn.com/ISRCTN11417025. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/56957.

"Anything that would help is a positive development": feasibility, tolerability, and user experience of smartphone-based digital phenotyping for people with and without type 2 diabetes.

Background: Digital phenotyping, the in-situ collection of passive (phone sensor) and active (daily surveys) data using a digital device, may provide new insights into the complex relationship between daily behaviour and mood for people with type 2 diabetes. However, there are critical knowledge gaps regarding its use in people with type 2 diabetes. This study assessed feasibility, tolerability, and user experience of digital phenotyping in people with and without type 2 diabetes after participation in a 2-month digital phenotyping study in Ireland. At study completion, participants rated methodology elements from "not a problem" to a "serious problem" on a 5-point scale and reported their comfort with the potential future use of digital phenotyping in healthcare, with space for qualitative expansion. Results: Eighty-two participants completed baseline. Attrition was 18.8%. Missing data ranged from 9-44% depending on data stream. Sixty-eight participants (82.9%) completed the user experience questionnaire (51.5% with type 2 diabetes; 61.8% female; median age-group 50-59). Tolerability of digital phenotyping was high, with "not a problem" being selected 76.5%-89.7% of the time across questions. People with type 2 diabetes (93.9%) were significantly more likely to be comfortable with their future healthcare provider having access to their digital phenotyping data than those without (53.1%), χ2 (1) = 14.01, p = < .001. Free text responses reflected a range of positive and negative experiences with the study methodology. Conclusions: An uncompensated, 2-month digital phenotyping study was feasible among people with and without diabetes, with low attrition and reasonable missing data rates. Participants found digital phenotyping to be acceptable, and even enjoyable. The potential benefits of digital phenotyping for healthcare may be more apparent to people with type 2 diabetes than the general population. Supplementary Information: The online version contains supplementary material available at 10.1186/s44247-024-00116-6.

Assessment of health technology acceptability for remote monitoring of patients with COVID-19: A measurement model for user perceptions of pulse oximeters.

Objective: This study aims to develop a measurement model for health technology acceptability using a theoretical framework and a range of validated instruments to measure user experience, acceptance, usability, health and digital health literacy. Methods: A cross-sectional evaluation study using a mixed-methods approach was conducted. An online survey was administered to patients who used a pulse oximeter in a virtual hospital setting during COVID-19. The model development was conducted in three steps: (1) exploratory factor analysis for conceptual model development, (2) measurement model confirmation through confirmatory factor analysis followed by structural equation modelling and (3) test of model external validity on four outcome measures. Finally, the different constructs of the developed model were used to compare two types of pulse oximeters by measuring the standardised scores. Results: Two hundred and two participants were included in the analysis, 37.6% were female and the average age was 53 years (SD:15.38). A four-construct model comprising Task Load, Affective Attitude, Self-Efficacy and Value of Use (0.636-0.857 factor loadings) with 12 items resulted from the exploratory factor analysis and yielded a good fit (RMSEA = .026). Health and digital health literacy did not affect the overall reliability of the model. Frustration, performance, trust and satisfaction were identified as outcomes of the model. No significant differences were observed in the acceptability constructs when comparing the two pulse oximeter devices. Conclusions: This article proposes a model for the measurement of the acceptability of health technologies used by patients in a remote care setting based on the use of a pulse oximeter in COVID-19 remote monitoring.

Hybrid mHealth care: Patient perspectives of blended treatments for psychosis. A systematic review.

BACKGROUND: mHealth interventions use mobile and wireless technologies to deliver aspects of healthcare, and have been extensively employed in mental health research, showcasing their potential to address the significant treatment gap. While numerous studies underscore the advantages and functionalities of mHealth, challenges persist regarding patient uptake and sustained engagement among individuals with psychosis spectrum disorder. This review aims to explore individual-level barriers and facilitators to engagement with hybrid digital systems, which involves the integration of digital tools alongside in-person care. METHOD: Four electronic databases (Medline, Web of Science, CINAHL, and PsychINFO) were systematically searched to identify hybrid digital interventions for psychosis spectrum disorders. Studies that only reported the efficacy of the interventions were excluded. 16 studies were included in the final review. RESULTS: Six themes were identified in this review, including mHealth as a tool to aid communication, the central role of the therapist, an increased sense of support through the provision of digital support, allowing greater insight into auditory hallucinations, enabling technologies and barriers to engagement. CONCLUSIONS: This review demonstrated the factors impacting engagement in hybrid interventions for psychosis spectrum disorder. By identifying barriers and facilitators, the findings could offer valuable guidance for the design of innovative digital interventions. These findings also underscore the importance of prioritising trustworthiness in digital systems. Future research should focus on establishing and implementing trustworthy digital systems to enhance engagement and effectively integrate mobile health into conventional healthcare practices.

An internet-based self-help intervention for the reduction of consumption of ultra-processed products and increase of physical activity in Mexican university population: study protocol for a randomized controlled trial.

Introduction: The consumption of ultra-processed products has been associated with the etiology of various diseases, mainly metabolic diseases. On the other hand, physical activity acts as a protective factor that helps prevent the appearance of this type of disease. In addition to the physical effects, both the consumption of ultra-processed products (UPPs) and sedentary behaviors have been associated with a significant impact on people's mental health. These problems occur significantly in university students. Online internet interventions are an alternative that has the advantage of reaching a broader sample size and adapting to various problems. Methods: A randomized controlled clinical superiority trial with two independent groups will be developed with 176 participants. Participants in both groups will be evaluated in 5 steps: (1) pretest, (2) middle of the intervention, (3) post-test, (4) follow-up at 3 months, and (5) follow-up at 6 months. In the experimental group ("UNISALUD"), participants will receive an intervention composed of 11 sessions with interactive elements such as videos, audio, and infographics created through the user experience (UX) principles and based on the health action process approach (HAPA). The participants in the control group will be on the waiting list and will receive treatment 27 days after fulfilling the inclusion criteria. Thus, participants will not receive the treatment immediately. Discussion: The study is expected to establish the feasibility of a self-help internet-based intervention created based on the user experience methodology and the health action process model, leading to a significant decrease and increase in the consumption of UPPs, ultra-healthy products, and physical activity, respectively. Conclusion: Internet-based interventions are scarce in Latin America. Due to their potential, this study will provide data about consumption of UPPs, physical activity, and mental health of the Mexican population, which will influence the reduction of health-related complications through prevention strategies or measures.Clinical Trial Registration:ClinicalTrials.gov, NCT05834842.

Usability of a smartphone-compatible, confocal micro-endoscope for cervical cancer screening in resource-limited settings.

BACKGROUND: More efficient methods to detect and treat precancerous lesions of the cervix at a single visit, such as low-cost confocal microscopy, could improve early diagnosis and hence outcomes. We piloted a prototype smartphone-compatible confocal micro-endoscope (SCME) among women presenting to a public cervical cancer screening clinic in Kampala, Uganda. We describe the piloting of the SCME device at an urban clinic used by lower cadre staff. METHODS: We screened women aged 18 and 60 years, who presented for cervical cancer screening at the Kawempe National Referral Hospital Kampala, and evaluated the experience of their providers (nurses). Nurses received a 2-day training by the study doctors on how to use the SCME, which was added to the standard Visual Inspection with Acetic acid (VIA)-based cervical cancer screening. The SCME was used to take colposcopy images before and after VIA at positions 12 and 6 O'clock if VIA negative, and on precancer-suspicious lesions if VIA positive. We used questionnaires to assess the women's experiences after screening, and the experience of the nurses who operated the SCME. RESULTS: Between November 2021 and July 2022, we screened 291 women with a median age of 36 years and 65.7% were HIV positive. Of the women screened, 146 were eligible for VIA, 123 were screened with the SCME, and we obtained confocal images from 103 women. Of those screened with the SCME, 60% found it comfortable and 81% were willing to screen again with it. Confocal images from 79% of the women showed distinguishable cellular features, while images from the remaining 21% were challenging to analyze. Nurses reported a mean score of 85% regarding the SCME's usefulness to their work, 71% regarding their satisfaction and willingness to use it again, 63% in terms of ease of use, and 57% concerning the ease of learning how to operate the SCME. CONCLUSION: Our findings demonstrate the feasibility of using the SCME by lower cadre staff in low-resource settings to aid diagnosis of precancerous lesions. However, more work is needed to make it easier for providers to learn how to operate the SCME and capture high-quality confocal images.

General practitioners' user experience of the nationwide digital decision support system in primary care.

Objectives: The aim of the study is to describe the user experiences of a nationwide digital decision support system (DDSS). Summary of background data: DDSSs have the potential to improve the quality and safety of healthcare services by supporting clinical decision-making with evidence-based recommendations. Due to a lack of knowledge, it is difficult to assess whether DDSSs are fulfilling their purpose. In Estonia, a nationwide DDSS for general practitioners (GPs) was implemented in 2020. To understand the impact of DDSS on the quality of care in the Estonian context and meet the demands of healthcare, it is necessary to gather information about the experiences of the users. This is the first study that examines the experiences of GPs on the use of DDSS nationwide. Methods: A qualitative descriptive study was conducted based on snowball sampling. Semi-structured interviews were performed in February-March 2022 with nine GPs. Data were analyzed by thematic analysis. A total of six themes and 16 subthemes emerged from the data. Results: A total of six themes and 16 subthemes emerged from the data. The following themes were identified: user-friendliness, DDSS use in clinical practice, benefits of the DDSS, and the impact of the DDSS on GPs' work, barriers to using the DDSS, and suggestions for improving the user experience. The results of the study are important, as they address and contribute to the relevant aspects of digital health in primary care. Conclusion: GPs shared their individual user experiences, including user-perceived barriers and enabling factors that influence the implementation and use of a decision support system in primary care settings. It is revealed that GPs have different benefits and barriers depending on the topic discussed. Future research should evaluate the functioning of the DDSS and the quality of the decisions it provides by observing and evaluating patient records. Systematic user experiences need to be collected and examined to ensure the usability and sustainability of the DDSS.

User experience with HIV molecular epidemiology in research, surveillance, and cluster detection and response: a needs assessment.

OBJECTIVE: HIV molecular epidemiology (HIV ME) is a tool that aims to improve HIV research, surveillance, and cluster detection and response. HIV ME is a core pillar of the U.S. initiative to End the HIV Epidemic but faces some challenges and criticisms from stakeholders. We sought to assess user experience to identify the current needs for HIV ME. METHODS: Users of HIV ME, including researchers and public health practitioners, were engaged via a structured survey. Needs were assessed via open-ended questions about HIV ME. Data were analyzed using reflexive thematic analysis; the concordance of results was assessed semi-quantitatively. RESULTS: Of 90 possible HIV-ME end-users, 57 completed the survey (response rate = 63%), which included users engaged in research (n = 29) and public health (n = 28). Respondents identified current imperatives, challenges, and strategies to improve HIV ME. Imperatives included characterization of the virus, identification of HIV hotspots, and tailoring of HIV interventions. Challenges encompassed technological issues, ethical concerns, and implementation difficulties. Strategies to improve HIV ME involved improving data access and analysis, enhancing implementation guidance and resources, and fostering community engagement and support. Researchers and public health practitioners prioritized different imperatives, but similarly emphasized the ethical concerns with HIV ME. CONCLUSION: The imperatives identified by users underscore the necessity of HIV ME, while the challenges highlight the hurdles to be overcome, including ethical concerns which emerged as a shared emphasis across user groups. The strategies outlined offer a roadmap for overcoming these challenges. These insights, drawn from user experience, present a valuable opportunity to inform the development of guidelines for the ethical application of HIV ME in research, surveillance, and cluster detection and response.

User Experience of a (Semi-) Automated Cognitive Phone-Based Assessment Within a Memory Clinic Population.

OBJECTIVE: We examined the user experience in different modalities (face-to-face, semi-automated phone-based, and fully automated phone-based) of cognitive testing in people with subjective cognitive decline and mild cognitive impairment. METHOD: A total of 67 participants from the memory clinic of the Maastricht University Medical Center+ participated in the study. The study consisted of cognitive tests in different modalities, namely, face-to-face, semi-automated phone-based guided by a researcher, and fully automated phone-based without the involvement of a researcher. After each assessment, a user experience questionnaire was administered, including questions about, for example, satisfaction, simplicity, and missing personal contact, on a seven-point Likert scale. Non-parametric tests were used to compare user experiences across different modalities. RESULTS: In all modalities, user experiences were rated above average. The face-to-face ratings were comparable to the ratings of the semi-automated phone-based assessment, except for the satisfaction and recommendation items, which were rated higher for the face-to-face assessment. The face-to-face assessment was preferred above the fully automated phone-based assessment on all items. In general, the semi- and fully automated phone-based assessments were comparable (simplicity, conceivability, quality of sound, visiting the hospital, and missing personal contact), while on all the other items, the semi-automated phone-based assessment was preferred. CONCLUSIONS: User experience was rated high within all modalities. Simplicity, conceivability, comfortability, and participation scores were comparable in the semi-automated phone-based and face-to-face assessment. Based on these findings and earlier research on validation of the semi-automated phone-based assessment, the semi-automated assessment could be useful for screening for clinical trials, and after more research, in clinical practice.

Mobile-linked point-of-care diagnostics in community-based healthcare: a scoping review of user experiences.

BACKGROUND: While mobile-linked point-of-care diagnostics may circumvent geographical and temporal barriers to efficient communication, the use of such technology in community settings will depend on user experience. We conducted a scoping review to systematically map evidence on user experiences of mobile-linked point-of-care diagnostics in community healthcare settings published from the year 2016 up to the year 2022. METHODOLOGY: We conducted a comprehensive search of the following electronic databases: Scopus, Web of Science, and EBSCOhost (Medline, CINAHL, Africa-wide, Academic Search Complete). The inter-reviewer agreement was determined using Cohen's kappa statistic. Data quality was appraised using the mixed method appraisal tool version 2018, and the results were reported according to the preferred reporting items for systematic reviews and meta-analyses for scoping reviews (PRISMA-ScR). RESULTS: Following the abstract and full article screening, nine articles were found eligible for inclusion in data extraction. Following the quality appraisal, one study scored 72.5%, one study scored 95%, and the remaining seven studies scored 100%. Inter-rater agreement was 83.54% (Kappa statistic = 0.51, p < 0.05). Three themes emerged from the articles: approaches to implementing mobile-linked point-of-care diagnostics, user engagement in community-based healthcare settings, and limited user experiences in mobile-linked point-of-care diagnostics. User experiences are key to the sustainable implementation of mobile-linked point-of-care diagnostics. User experiences have been evaluated in small community healthcare settings. There is limited evidence of research aimed at evaluating the usability of mobile-linked diagnostics at the community level. CONCLUSION: More studies are needed to assess the user experience of mobile-linked diagnostics in larger communities. This scoping review revealed gaps that need to be addressed to improve user experiences of mobile-linked diagnostics, including language barriers, privacy issues, and clear instructions.

Feasibility and Acceptability of a Mobile Health Exercise Intervention for Inactive Adults: 3-Arm Randomized Controlled Pilot Trial.

BACKGROUND: Objective monitoring of self-directed physical activity (PA) is a common approach used in both fitness and health settings to promote exercise behavior, but adherence has been poor. Newer mobile health (mHealth) technologies could be a cost-effective approach to broadening accessibility and providing support for PA behavior change; yet, the optimal method of delivery of such interventions is still unclear. OBJECTIVE: This study aimed to determine the feasibility and acceptability of an mHealth exercise intervention delivered in combination with objective monitoring in 3 ways: health education emails, asynchronous exercise videos, or synchronous videoconference exercise classes. METHODS: Physically inactive (<30 min/wk) adults (cisgender women aged 31.5, SD 11.3 years, cisgender men aged 34.1, SD 28.9 years, and nonbinary individuals aged 22.0, SD 0 years) were randomized (1:1:1) to 8 weeks of increasing PA behavioral support: level 1 (health education+objective monitoring, n=26), level 2 (asynchronous contact, level 1+prerecorded exercise videos, n=30), or level 3 (synchronous contact, level 1+videoconference group exercise, n=28). Participants used a heart rate monitor during exercise and a mobile app for interaction. Primary outcomes were feasibility (accrual, retention, and adherence) and acceptability (user experience survey). Secondary outcomes assessed at baseline and 8 weeks included resting heart rate, self-reported PA, and quality of life. The exercise dose was evaluated throughout the intervention. RESULTS: Between August 2020 and August 2021, 204 adults were screened for eligibility. Out of 135 eligible participants, 84 (62%) enrolled in the study. Retention was 50% (13/26) in level 1, 60% (18/30) in level 2 and 82% (23/28) in level 3, while adherence was 31% (8/26) in level 1, 40% (12/30) in level 2 and 75% (21/28) in level 3. A total of 83% (70/84) of the study sample completed the intervention, but low response rates (64%, 54/84) were observed postintervention at week-8 assessments. Program satisfaction was highest in participants receiving exercise videos (level 2, 80%, 8/10) or exercise classes (level 3, 80%, 12/15), while only 63% (5/8) of level 1 reported the program as enjoyable. Level 3 was most likely to recommend the program (87%, 13/15), compared to 80% (8/10) in level 2 and 46% (5/8) in level 1. Self-reported PA significantly increased from baseline to intervention in level 3 (P<.001) and level 2 (P=.003), with no change in level 1. Level 3 appeared to exercise at higher doses throughout the intervention. CONCLUSIONS: Only the videoconference exercise class intervention met feasibility criteria, although postintervention response rates were low across all groups. Both videoconference and prerecorded videos had good acceptability, while objective monitoring and health education alone were not feasible or acceptable. Future studies are needed to examine the effectiveness of videoconference exercise interventions on health-related outcomes during nonpandemic times and how asynchronous interventions might maximize adherence. TRIAL REGISTRATION: ClinicalTrials.gov NCT05192421; https://clinicaltrials.gov/study/NCT05192421.

Analysis of the effectiveness and user experience of employing virtual reality to enhance the efficacy of occupational safety and health learning for electrical workers and graduate students.

Introduction: The integration of engineering approaches in education and training is pivotal for reducing workplace incidents. Effective safety education increases workers' awareness of potential risks and fosters a robust Occupational Safety and Health (OSH) culture. Virtual reality (VR) offers immersive experiences that enhance the efficacy of safety training. Method: This study evaluated VR's effectiveness through two experiments that demonstrated improved learning capacities. The first study employed quantitative methods and quasi-experiments with electrical sector technical support professionals. The second study used a qualitative approach with scenario case studies involving graduate students. Results: The quantitative study revealed significant improvements in OSH understanding among electrical workers, highlighting VR-based training's superiority over traditional methods. The qualitative study found positive outcomes in VR usability and user experience among graduate students, affirming VR's effectiveness in OSH education. Conclusion: VR has proven to be an effective and efficient training tool for both graduate students and experienced workers. It significantly advances skills, knowledge, and proficiency in electrical engineering by providing realistic, immersive, and tailored learning experiences. As VR technology continues to evolve, its role in shaping the future of electrical technical education and training appears increasingly promising.

Factors influencing the use of big data within healthcare services: a systematic review.

Background: The emergence of big data holds the promise of aiding healthcare providers by identifying patterns and converting vast quantities of data into actionable insights facilitating the provision of precision medicine and decision-making. Objective: This study aimed to investigate the factors influencing use of big data within healthcare services to facilitate their use. Method: A systematic review was conducted in February 2024, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Database searches for articles published between 01 January 2020 and 18 February 2024 and included PubMed, Scopus, ProQuest and Cochrane Library. The Authority, Accuracy, Coverage, Objectivity, Date, Significance ( AACODS) checklist was used to evaluate the quality of the included articles. Subsequently, a thematic analysis was conducted on the findings of the review, using the Boyatzis approach. Results: A final selection of 46 studies were included in this systematic review. A significant proportion of these studies demonstrated acceptable quality, and the level of bias was deemed satisfactory. Thematic analysis identified seven major themes that influenced the use of big data in healthcare services. These themes were grouped into four primary categories: performance expectancy, effort expectancy, social influence, and facilitating conditions. Factors associated with "effort expectancy" were the most highly cited in the included studies (67%), while those related to "social influence" received the fewest citations (15%). Conclusion: This study underscored the critical role of "effort expectancy" factors, particularly those under the theme of "data complexity and management," in the process of using big data in healthcare services. Implications: Results of this study provide groundwork for future research to explore facilitators and barriers to using big data in health care, particularly in relation to data complexity and the efficient and effective management of big data, with significant implications for healthcare administrators and policymakers.

Effectiveness and User Experience of a Smoking Cessation Chatbot: Mixed Methods Study Comparing Motivational Interviewing and Confrontational Counseling.

BACKGROUND: Cigarette smoking poses a major public health risk. Chatbots may serve as an accessible and useful tool to promote cessation due to their high accessibility and potential in facilitating long-term personalized interactions. To increase effectiveness and acceptability, there remains a need to identify and evaluate counseling strategies for these chatbots, an aspect that has not been comprehensively addressed in previous research. OBJECTIVE: This study aims to identify effective counseling strategies for such chatbots to support smoking cessation. In addition, we sought to gain insights into smokers' expectations of and experiences with the chatbot. METHODS: This mixed methods study incorporated a web-based experiment and semistructured interviews. Smokers (N=229) interacted with either a motivational interviewing (MI)-style (n=112, 48.9%) or a confrontational counseling-style (n=117, 51.1%) chatbot. Both cessation-related (ie, intention to quit and self-efficacy) and user experience-related outcomes (ie, engagement, therapeutic alliance, perceived empathy, and interaction satisfaction) were assessed. Semistructured interviews were conducted with 16 participants, 8 (50%) from each condition, and data were analyzed using thematic analysis. RESULTS: Results from a multivariate ANOVA showed that participants had a significantly higher overall rating for the MI (vs confrontational counseling) chatbot. Follow-up discriminant analysis revealed that the better perception of the MI chatbot was mostly explained by the user experience-related outcomes, with cessation-related outcomes playing a lesser role. Exploratory analyses indicated that smokers in both conditions reported increased intention to quit and self-efficacy after the chatbot interaction. Interview findings illustrated several constructs (eg, affective attitude and engagement) explaining people's previous expectations and timely and retrospective experience with the chatbot. CONCLUSIONS: The results confirmed that chatbots are a promising tool in motivating smoking cessation and the use of MI can improve user experience. We did not find extra support for MI to motivate cessation and have discussed possible reasons. Smokers expressed both relational and instrumental needs in the quitting process. Implications for future research and practice are discussed.

Exploring User Experiences of the Mom2B mHealth Research App During the Perinatal Period: Qualitative Study.

BACKGROUND: Perinatal depression affects a significant number of women during pregnancy and after birth, and early identification is imperative for timely interventions and improved prognosis. Mobile apps offer the potential to overcome barriers to health care provision and facilitate clinical research. However, little is known about users' perceptions and acceptability of these apps, particularly digital phenotyping and ecological momentary assessment apps, a relatively novel category of apps and approach to data collection. Understanding user's concerns and the challenges they experience using the app will facilitate adoption and continued engagement. OBJECTIVE: This qualitative study explores the experiences and attitudes of users of the Mom2B mobile health (mHealth) research app (Uppsala University) during the perinatal period. In particular, we aimed to determine the acceptability of the app and any concerns about providing data through a mobile app. METHODS: Semistructured focus group interviews were conducted digitally in Swedish with 13 groups and a total of 41 participants. Participants had been active users of the Mom2B app for at least 6 weeks and included pregnant and postpartum women, both with and without depression symptomatology apparent in their last screening test. Interviews were recorded, transcribed verbatim, translated to English, and evaluated using inductive thematic analysis. RESULTS: Four themes were elicited: acceptability of sharing data, motivators and incentives, barriers to task completion, and user experience. Participants also gave suggestions for the improvement of features and user experience. CONCLUSIONS: The study findings suggest that app-based digital phenotyping is a feasible and acceptable method of conducting research and health care delivery among perinatal women. The Mom2B app was perceived as an efficient and practical tool that facilitates engagement in research as well as allows users to monitor their well-being and receive general and personalized information related to the perinatal period. However, this study also highlights the importance of trustworthiness, accessibility, and prompt technical issue resolution in the development of future research apps in cooperation with end users. The study contributes to the growing body of literature on the usability and acceptability of mobile apps for research and ecological momentary assessment and underscores the need for continued research in this area.

Evaluating the real-world usability of BCI control systems with augmented reality: a user study protocol.

Brain-computer interfaces (BCI) enable users to control devices through their brain activity. Motor imagery (MI), the neural activity resulting from an individual imagining performing a movement, is a common control paradigm. This study introduces a user-centric evaluation protocol for assessing the performance and user experience of an MI-based BCI control system utilizing augmented reality. Augmented reality is employed to enhance user interaction by displaying environment-aware actions, and guiding users on the necessary imagined movements for specific device commands. One of the major gaps in existing research is the lack of comprehensive evaluation methodologies, particularly in real-world conditions. To address this gap, our protocol combines quantitative and qualitative assessments across three phases. In the initial phase, the BCI prototype's technical robustness is validated. Subsequently, the second phase involves a performance assessment of the control system. The third phase introduces a comparative analysis between the prototype and an alternative approach, incorporating detailed user experience evaluations through questionnaires and comparisons with non-BCI control methods. Participants engage in various tasks, such as object sorting, picking and placing, and playing a board game using the BCI control system. The evaluation procedure is designed for versatility, intending applicability beyond the specific use case presented. Its adaptability enables easy customization to meet the specific user requirements of the investigated BCI control application. This user-centric evaluation protocol offers a comprehensive framework for iterative improvements to the BCI prototype, ensuring technical validation, performance assessment, and user experience evaluation in a systematic and user-focused manner.

User Experience Design for Intensive Care Alarm Management.

Alarm fatigue is a pressing issue in intensive care units. Based on user experience design, including clinical shadowings and feedback loops, we developed a prototype for a redesigned patient monitor: The prototype moves away from today's threshold-based alarm systems. It combines a sleek design with machine learning driven clinical insights to mitigate alarm fatigue.

Physicians' Experiences of EHR Technical Quality: Results from Four Large Cross-Sectional Surveys in 2010-2021.

Unexpected downtime and long response times of electronic health record (EHR) systems not only impact user satisfaction and clinicians' work efficiency but also bring about potential harm for patients. Despite improvements in the performance of EHR systems' architecture, hardware, and networks, technical challenges continue to cause problems. We explored the end-user experiences of EHR technical functionality and quality from four large national cross-sectional surveys conducted among Finnish physicians in 2010-21. The results were analyzed by healthcare sector/specialty groups. In most groups, the experiences of stability and reaction speed became worse in 2010-17, which is readily explained by the implementation of the national patient data repository services, but improvements were seen in 2021, suggesting that EHR vendors have solved at least some of the slowness problems. The proportion of physicians reporting having experienced faulty system function with potential or actualized harm for the patient had decreased in operative and medical specialties and in the private sector but remained stable in other groups. Our findings underline the importance of continuing to develop technical qualities - including the implementations of national integrations.